Long Term Outcomes of African-American LVAD Recipients

Abstract

Despite significant advances in US CV health, ethnic disparities in outcomes persist. The prognosis of HF among African-Americans (AA) is less favorable than other groups. The impact of race on durable LVAD outcomes is not well defined. We therefore sought to determine the characteristics and long term outcomes of AA LVAD recipients. We performed a retrospective review of all LVAD recipients at a single center from October 1, 2006 to June 30, 2019. We compared clinical characteristics of AAs to non-AAs. Survival and rates of adverse events (AEs) for AA patients (pts) were determined. 571 pts were included in the analysis. 394 AA (69% of the population) underwent LVAD implantation. The mean follow up time of AA cohort was 670+617 days. The AA group was younger (54+13 vs 60+13, p<0.001), more likely to include women (34% vs 17%, p=0.003), have higher BMI (30+8 vs 27.5+7, p=0.001), history of HTN (67% vs 54%, p=0.003), and a NICM (71% vs 41%, P<0.001) when compared to non-AAs. Among the AA group, 43% of devices were implanted as BTT and 42% as DT. The mean length of stay for AA recipients during index admission for LVAD was 31+21 days vs. 25+19 days for non-AAs (p=0.002). The risk of AEs (EPPY) for AA patients including GI bleeding, stroke, pump thrombosis, infection, and acute heart failure are outlined in table 1. The 1 and 2 year survival for all AAs was 83% and 72% respectively (figure 1). Five year survival was 45%. In the largest ever reported cohort of AA LVAD recipients, AA were shown to have excellent long term survival with rates of AEs comparable to those reported in published clinical trials. Further research is warranted to determine predictors of survival in AA pts.