Table 4.
Utilization of Heart Failure Therapies Prior to LVAD Implantation
| COMPLETE RECOVERY | PARTIAL RECOVERY | |||||
|---|---|---|---|---|---|---|
| Variable | Explant (n= 163, 1.2%) |
No Explant (n= 13,291, 98.8%) |
p-value | LVEF (≥40%) (n= 761, 8.6%) |
LVEF (<40%) (n= 8,044, 91.4%) |
p-value |
| Medical Therapy | ||||||
| Beta-blocker | 0.008 | 0.038 | ||||
| Current Use | 72 (47.4%) | 7148 (55.4%) | 404 (55.0%) | 4287 (54.7%) | ||
| Prior Use | 31 (20.4%) | 2944 (22.8%) | 153 (20.8%) | 1906 (24.3%) | ||
| No | 49 (32.2%) | 2803 (21.7%) | 177 (24.1%) | 1642 (21.0%) | ||
| ACE inhibitors | 0.197 | 0.369 | ||||
| Current Use | 55 (35.7%) | 3783 (30.5%) | 212 (29.4%) | 2294 (30.5%) | ||
| Prior Use | 23 (14.9%) | 2468 (19.9%) | 142 (19.7%) | 1601 (21.3%) | ||
| No | 76 (49.4%) | 6155 (49.6%) | 366 (50.8%) | 3620 (48.2%) | ||
| ARB | 0.013 | 0.453 | ||||
| Current Use | 12 (7.8%) | 1165 (9.6%) | 59 (8.5%) | 704 (9.6%) | ||
| Prior Use | 2 (1.3%) | 851 (7.0%) | 47 (6.8%) | 544 (7.4%) | ||
| No | 139 (90.8%) | 10060 (83.3%) | 590 (84.8%) | 6055 (82.9%) | ||
| Aldosterone blocker | 0.030 | <0.001 | ||||
| Current Use | 52 (34.2%) | 5334 (42.5%) | 266 (37.5%) | 3343 (43.9%) | ||
| Prior Use | 17 (11.2%) | 1704 (13.6%) | 87 (12.3%) | 1105 (14.5%) | ||
| No | 83 (54.6%) | 5501 (43.9%) | 356 (50.2%) | 3161 (41.5%) | ||
| Device Therapy | ||||||
| ICD | 68 (37.4%) | 10854 (79.7%) | <0.001 | 503 (66.4%) | 6727 (84.0%) | <0.001 |
| CRT | 11 (14.1%) | 2348 (29.6%) | 0.003 | 100 (21.7%%) | 1641 (31.8%) | <0.001 |
| Optimal HF therapy* | 51 (32.5%) | 7789 (59.7%) | <0.001 | 355 (47.5%) | 4923 (62.0%) | <0.001 |
*
Defined as prior or current use of at least 2 neurohormonal blocking agents from 3 major drug classes (beta-blockers, ACE inhibitors/ARB, and Aldosterone antagonists) in combination with an ICD and/or CRT device.