Characterizing Sex-Specific Baseline Characteristics and Outcomes in Left Ventricular Assist Device (LVAD) Support

Abstract

Purpose Women are underrepresented in the patient population who receive left ventricular assist devices (LVAD) as a therapy for advanced heart failure (HF). A limited number of studies suggest greater adverse outcomes in women on LVAD support than in men. This study aims to expand the sex-based data on the growing female LVAD population. Methods Single-center retrospective of 25 women and 126 men in their first 12 months of LVAD support were analyzed using IBM SPSS Statistics V. 24.0. Adverse events were categorized using the INTERMACS Appendix. Results The mean ages for female and male patients were 48.0 ± 18.0 and 57.0 ± 12.0 years, respectively (p = 0.002). Women were more likely to be listed for heart transplant prior to LVAD implantation (76% vs 54%, p = 0.042), the etiology of HF was more often non-ischemic in origin (79% vs 52%, p = 0.013) and Cr was lower (1.0 vs 1.4 mg/dL, p = 0.001). No other statistically significant differences existed at baseline between the two cohorts, including baseline NYHA class, INTERMACS status, BMI, type of LVAD device, or medications prior to implant. There were no significant differences in outcomes including readmission, bleeding, infection, neurological events, or right heart failure within the first year. Time to first neurological event was longer in women (7 months vs 2 months, p = 0.008). There was no difference in risk of death in the first year. Conclusion Although younger and non-ischemic, women with LVADs experience similar first year outcomes as men.