Abstract 18010: Trends in CardioMEMS Use Among Patients With Heart Failure in the US

Abstract

Introduction: The implantable pulmonary artery pressure (PAP) monitor, CardioMEMS, has been shown to reduce heart failure (HF) hospitalizations and improve quality of life among patients with symptomatic heart failure. However, uptake of the CardioMEMS device has been limited, and its utilization across sociodemographic groups has not been studied. Methods: This was a retrospective study of commercially insured patients in the US from October 1, 2015 to October 1, 2020, using the Optum Clinformatics Data Mart. Adult patients (age > 18) with heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) were included in the analysis. Multivariable logistic regression models were used to assess the factors associated with CardioMEMS placement. Results: There were 501,755 HFpEF and HFrEF patients who met inclusion criteria. Of these, 1,042 (0.002%) had CardioMEMs devices implanted. Rate of CardioMEMS implantation has increased over the last 6 years (0.04% in 2015 vs. 0.35% in 2021) but remains low, particularly among Asian and Hispanic patients (Figure 1). In a multivariable analysis, compared to patients who did not have a CardioMEMS device, those who did were more likely to have a higher income (>$100,000) (Adjusted odds ratio (AOR) 1.39, 1.16-1.67, p<0.001). Patients in the Southern United States (AOR 0.52, CI 0.43-0.62, p<0.0001) and older patients (AOR: 0.96, CI 0.95-0.96, p <0.001) were less likely to have a CardioMEMS device implanted. Patients with CardioMEMS were more likely to have chronic kidney disease, obesity, and valvular pathology (p <0.0001). No gender differences were seen in CardioMEMS utilization. Conclusions: Overall utilization of the CardioMEMS device is low, but rising. CardioMEMS utilization is not distributed equally across demographic groups—younger patients and those with higher incomes were more likely to have the device implanted.