Abstract 12557: INTERMACS Profiles and Clinical Outcomes Among Ambulatory Patients With Systolic Heart Failure

Abstract

Introduction: The Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profiles are used to classify patients with heart failure (HF) considered for mechanical circulatory support (MCS). Limited data exist on the prognostic value of INTERMACS profiles in the general ambulatory HF population. Hypothesis: INTERMACS profiles identify systolic HF outpatients with distinct disease trajectories. Methods: We evaluated INTERMACS profiles, mortality, and healthcare resources utilization in 474 HF outpatients with left ventricular ejection fraction ≤40% who received care during a 3-month period in 2012 and were not on advanced therapies (MCS, heart transplant, or palliative inotropes). Patients whose HF severity did not meet any INTERMACS profile were classified as stage C. Results: Table 1 presents the distribution of patient characteristics across INTERMACS profiles. After a median follow-up of 3.1 years (interquartile range 1.6, 3.3), 95 patients died (3-year mortality 21.4%); 24 patients received MCS; and 11 received heart transplant (combined 3-year mortality, MCS, and transplant: 29.3%). Compared to stage C patients, mortality and hospitalization rates were higher in all INTERMACS profiles, Table 2 . Patients with profiles 4-5 demonstrated mortality and hospitalization rates similar to those with profiles 2-3, despite a higher use of advanced therapies in the latter. Conclusions: In ambulatory HF patients, all INTERMACS profiles are associated with significantly higher mortality and hospitalization rates compared to stage C patients. Outcomes in patients with profiles 2-3 are similar to those with the theoretically more benign profiles 4-5.