Overcoming Racial Disparities: Towards Equitable Care in Left Ventricular Assist Device Patients

Abstract

<h3>Purpose</h3> Literature has reported conflicting findings on racial disparities in clinical outcomes in patients with advanced heart failure. In this study, we sought to investigate whether racial differences influence clinical outcomes after LVAD implantation. <h3>Methods</h3> We retrospectively analyzed 208 patients who underwent durable LVAD implantation at a US tertiary medical center between January 2010 and April 2020. Patients were divided into three racial groups: Caucasian (45.4%), African American (44.4%), or Other (7.9%) and compared for all-cause mortality and freedom from readmissions. <h3>Results</h3> No difference in survival was seen between the two racial groups at 1 year (P=0.36) and 3 years (P=0.59). Similarly, no difference in freedom from readmission was seen between the two groups at 1 year (P=0.468) and 3 years (P=0.521). After adjusting for relevant covariates, African American race was not a significant predictor of reduced survival at 1 year (HR, 1.88; 95% CI, 0.40-8.85; P=0.42) or 3 years (HR, 1.11; 95% CI, 0.45-2.7; P=0.83). When distinguished, Asian and Hispanic patients did not have significantly different outcomes from Black or White patients (data not shown due to small sample size). <h3>Conclusion</h3> In this single center retrospective study, African American patients had similar survival to Caucasian patients in both the short- and long-term after LVAD implantation, and that patients of all races have similar clinical outcomes following LVAD despite different preoperative clinical profiles. Optimal care in a comprehensive, multi-disciplinary cardiac center with program-wide patient assistance and risk mitigation measures may help eliminate racial disparity in clinical outcomes for LVAD patients.