Table 3.
Comparison of comorbid conditions and reasons for HT ineligibility in those patients who received destination therapy left ventricular assist device (DT LVAD) compared to those considered ineligible for any advanced heart failure therapy.
| DT LVAD N=71 |
Ineligible for Advanced Therapies | P-value | |||
|---|---|---|---|---|---|
|
| |||||
| Private N=120 |
Medicare N=119 |
Medicaid N=41 |
|||
|
| |||||
| Age, years | 54.6±11.6 | 52.1±12.1 | 55.7±12.8 | 42.6±13.5‡ | <0.0001 |
|
| |||||
| Race | 0.06 | ||||
| • White | 36 (50.7) | 54 (50.7) | 51 (42.9) | 9 (22.0) | |
| • Black | 33 (46.5) | 57 (47.5) | 62 (52.1) | 30 (73.2)‡ | |
| • Other | 2 (2.8) | 9 (7.5) | 6 (5.0) | 2 (4.9) | |
|
| |||||
| Male | 34 (47.9) | 75 (62. 5)* | 77 (64.7)§ | 24 (58.5) | 0.1 |
|
| |||||
| Lung Disease | 12 (16.9) | 10 (8.3) | 23 (19.3) | 8 (19.5) | 0.08 |
|
| |||||
| LV thrombus | 7 (9.9) | 12 (10.0) | 14 (11.8) | 5 (12.2) | 0.9 |
|
| |||||
| Inotrope Dependent | 60 (84.5) | 44 (36.7)* | 64 (53.8)§ | 22 (53.7)‡ | <0.0001 |
|
| |||||
| BMI, kg/m2 | 31.6±8.1 | 30.1±7.6 | 29.6±7.8 | 27.1±6.7‡ | 0.03 |
|
| |||||
| Albumin, g/dL | 3.4±0.5 | 3.5±0.6 | 3.4±0.5 | 3.4±0.7 | 0.4 |
|
| |||||
| Total bilirubin, mg/dL | 1.4±1.1 | 1.5±1.3 | 1.6±1.1 | 1.9±1.5 | 0.2 |
|
| |||||
| Creatinine, mg/dL | 1.4±0.5 | 1.5±0.7 | 1.6±0.9 | 1.3±0.3 | 0.08 |
|
| |||||
| eGFR, ml/min/1.73 m2 | 53.6±20.0 | 57.7±25.0 | 56.1±25.0 | 69.4±23.4‡ | 0.007 |
|
| |||||
| Hemoglobin, g/dL | 12.2±2.1 | 11.8±2.4 | 11.9±2.1 | 11.9±2.2 | 0.7 |
|
| |||||
| CKD stage | 0.002 | ||||
| • 1–2 | 23 (32.4) | 52 (43.3) | 49 (41.2) | 28 (68.3)‡ | |
| • 3 | 42 (59.2) | 50 (41.7) | 55 (46.2) | 13 (31.7)‡ | |
| • 4–5 | 6 (8.5) | 18 (15.0) | 15 (12.6) | 0 (0) | |
|
| |||||
| Sodium, mEq/L | 134.1±4.2 | 135.4±4.9 | 135.0±5.0 | 133.7±4.8 | 0.1 |
|
| |||||
| RAP, mmHg | 11.9±6.6 | 11.9±6.2 | 11.9±7.2 | 13.3±7.4 | 0.8 |
|
| |||||
| PCWP, mm Hg | 25.6±9.8 | 23.4±10.3 | 25.2±9.8 | 24.3±10.2 | 0.5 |
|
| |||||
| CI, L/min/m2 | 1.7±0.4 | 1.9±0.6 | 1.9±0.5 | 2.4±3.3‡ | 0.04 |
|
| |||||
| Active non-compliance | 2 (2.8) | 2 (1.7) | 1 (0.8) | 2 (4.9) | 0.3 |
|
| |||||
| Death/rapid deterioration | 2 (2.8) | 9 (7.5) | 9 (7.6) | 6 (14.6)‡ | 0.2 |
|
| |||||
| Inadequate financial resources | 0 (0) | 4 (3.3) | 2 (1.7) | 3 (7.3)‡ | 0.09 |
|
| |||||
| Inadequate social support | 1 (1.4) | 11 (9.2)* | 15 (12.6)§ | 9 (22.0)‡ | 0.003 |
|
| |||||
| Active substance abuse | 7 (9.9) | 11 (9.2) | 9 (7.6) | 3 (7.3) | 0.9 |
BMI, body mass index; CI, cardiac index; CKD, chronic kidney disease; DT, destination therapy; eGFR, estimated glomerular filtration rate; LV, left ventricle; RA, right atrial pressure; PCWP, pulmonary capillary wedge pressure.
*
P<0.05 between DT LVAD vs private
§
P<0.05, DT vs medicare
‡
P<0.05, DT vs Medicaid