Racial Differences in over 1000 Patients with Continuous Flow Left Ventricular Assist Devices

Abstract

Purpose This study examines racial disparities in advanced heart failure patients treated with left ventricular assist devices (LVAD). We hypothesize that specialized treatment in a comprehensive heart failure/assist device program results in similar survival amongst various ethnicities. Methods and Materials A retrospective analysis of HeartMate II clinical trial database was performed. Patients were categorized as Caucasians (Cau), African Americans (AA) and Others (Hispanics, Asians, other ethnic minorities). Variables analyzed included demographics, 2-year suvival and right heart failure and HeartMate II risk score (age, albumin, creatinine, INR). Results 637 of the total 1126 patients (53.6%) received LVAD as Destination Therapy. The baseline hemodynamics were similar between the groups except a significantly higher pulmonary vascular resistance in the AA (p=0.02). The HeartMate II risk score was significantly higher in Cau compared to other groups (p=0.004). No difference was seen in baseline renal or hepatic profiles. Survival by Kaplan-Meier analysis revealed a higher unadjusted survival (P Conclusions In patients with advanced heart failure, no difference in survival exists based on ethnicity. This is probably reflective of standardized medical care in treating all patient cohorts. Race Age (Years) Female Sex (N,%) LVEF (mean±SD) Ischemic Etiology (N,%) Right Heart Failure (Events/Patient-year) HeartMate II Risk score 2-year Survival (%) Caucasian (N=830) 61.0 ± 12.3 150(18%) 17.0 ± 6.1 517(62%) 200(0.15) 1.85 ± 1.28 58 ± 2.0% African American (N=215) 49.8 ± 14.7 83(39%) 15.3 ± 5.7 44(20%) 58(0.14) 1.65 ± 0.98 67 ± 3.8% Others (N=81) 56.3 ± 15.9 17(21%) 17.9 ± 5.7 38(47%) 21(0.13) 1.64 ± 0.93 77 ± 5.3% P value 0.73 0.004 p