Clinical, Social, and Behavioral Characteristics at Time of Implant in European Registry for Patients with Mechanical Circulatory Support (EUROMACS): Associations with Gender and Device Strategy

Abstract

The role of gender in the prognosis of continuous flow left ventricular assist device (CF-LVAD) recipients is poorly understood. We present gender differences in clinical, social, and behavioral characteristics by intended device strategy at time of implant, which may influence gender-specific outcomes. Analyses were based on data from 2,395 adult patients (16.8% women) enrolled in the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) and implanted with a primary CF-LVAD as bridge-to-transplant (BTT; n = 1,939, 17.6% female) or destination therapy (DT; n = 456, 13.4% female) between January 2011 to December 2017. Analyses of variance (ANOVAs) and Multinomial regression analyses were performed to test associations between gender, device strategy and baseline characteristics. Overall, compared to men, women were younger, less likely to be smoking, to be diagnosed with ischemic cardiomyopathy and diabetes; however, they were more likely to be in unstable clinical condition (INTERMACS profile 1 and 2), to have smaller BSA, to be divorced, separated or widowed. Men and women also differed within the intended device strategies. Especially women intended for BTT, were less likely to report alcohol abuse (χ2(1) = 6.23, p < .013). And especially women intended for DT, were less likely to work for an income (χ2(1) = 4.37, p < .036). Stratifying outcome research by gender and device strategy as well as considering social and behavioral health risks (in addition to clinical parameters) may help to elucidate the role of gender in outcomes post CF-LVAD implant.