Racial disparities and outcomes of left ventricular assist device implantation as a bridge to heart transplantation

Autor: Alexis Kofi Okoh, Mariam Selevanny, Supreet Singh, Sameer Hirji, Swaiman Singh, Nawar Al. Obaidi, Leonard Y. Lee, Margarita Camacho, Mark J. Russo
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: ESC Heart Failure, Vol 7, Iss 5, Pp 2744-2751 (2020)
Druh dokumentu: article
ISSN: 2055-5822
DOI: 10.1002/ehf2.12866
Popis: Abstract Aims This study investigated outcomes after continuous flow left ventricular assist device (CF‐LVAD) implantation as bridge to heart transplantation (BTT) in advanced heart failure patients stratified by race. Methods and results De‐identified data from the United Network for Organ Sharing database was obtained for all patients who had a CF‐LVAD as BTT from 2008 to 2018. Patients were stratified into four groups on the basis of ethnicity [Caucasian, African American (AA), Hispanic, and others (Asian, Pacific Islanders, and American Indian)]. Outcomes investigated were waitlist mortality or delisting and post‐transplant 5 year survival. Cox proportional hazards modelling was used to identify independent predictors of waitlist mortality or delisting and post‐transplant survival. We used Kaplan–Meier survival curves and the log‐rank test to estimate and compare survival among groups. A total of 14 234 patients who had CF‐LVADs as BTT were identified. Of these, 64% (n = 9058) were Caucasians, 26% (n = 3677) were AA, 7% (n = 997) were Hispanic, and 3% (n = 502) had a different race. Compared with Caucasian, AA, and Hispanic patients had higher body mass indexes and a lower level of education and are more likely to be public health insurance beneficiaries. There was a significantly lower incidence of transplantation in AAs compared with Caucasians, Hispanics, and others at 12, 24, and 60 months, respectively (Gray's test, P
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