Table 1.
Baseline Characteristics of Patients Providing Blood Samples
| Number of blood samples (N = 644)a | HF NYHA Class I (N = 12) | HF NYHA Class II (N = 55) | HF NYHA Class III (N = 73) | HF NYHA Class IV (N = 94) | LVAD (≥3 months) (N = 210) | HT ≥6 months) (N = 200) | p-value for any difference |
|---|---|---|---|---|---|---|---|
| Demographic and clinical characteristics | |||||||
| Age, years | 53.9 (4.90) | 59.8 (1.77) | 60.5 (1.44) | 58.6 (1.45) | 57.9 (0.97) | 55.3 (0.94) | <0.0001 |
| Sex, male | 9 (75.0) | 39 (70.9) | 60 (82.2) | 79 (84.0) | 186 (88.6) | 166 (83.0) | 0.0492 |
| Race | 0.0168 | ||||||
| White | 3 (25.0) | 25 (45.5) | 44 (60.3) | 55 (58.5) | 120 (57.1) | 109 (54.5) | |
| Black | 3 (25.0) | 14 (25.5) | 19 (26.0) | 16 (17.0) | 53 (25.2) | 59 (29.5) | |
| Hispanic | 3 (25.0) | 5 (9.1) | 7 (9.6) | 7 (7.4) | 17 (8.1) | 19 (9.5) | |
| Other | 3 (25.0) | 11 (20.0) | 3 (4.1) | 16 (17.0) | 20 (9.5) | 13 (6.5) | |
| BMI (kg/m2) | 32.98 (3.36) | 30.39 (1.25) | 31.23 (1.00) | 29.59 (1.42) | 28.64 (0.49) | 30.47 (0.86) | 0.06041 |
| History of smoking | 4 (33.3) | 24 (43.6) | 40 (54.8) | 47 (50.0) | 121 (57.6) | 88 (44.0) | 0.0539 |
| Ischemic etiology | 2 (16.7) | 23 (41.8) | 35 (47.9) | 39 (31.5) | 98 (46.7) | 79 (39.5) | 0.2698 |
| Hypertension | 5 (41.7) | 38 (69.1) | 44 (60.3) | 58 (61.7) | 132 (62.9) | 157 (78.5) | 0.0013 |
| Diabetes | 1 (8.3) | 16 (29.1) | 26 (35.6) | 29 (30.9) | 79 (37.6) | 77 (38.5) | 0.2247 |
| Atrial fibrillation | 3 (25.0) | 17 (30.9) | 35 (47.9) | 47 (50.0) | 94 (44.8) | 71 (35.5) | 0.0206 |
| History of stroke | 0 (0) | 1 (1.8) | 5 (6.8) | 8 (8.5) | 17 (8.1) | 19 (9.5) | 0.4509 |
| INTERMACS profile | |||||||
| 1 | — | — | — | 5 (5.3) | — | — | |
| 2 | — | — | — | 49 (52.1) | — | — | |
| 3 | — | — | — | 21 (22.3) | — | — | |
| 4 | — | — | — | 1 (1.1) | — | — | |
| NA | — | — | — | 18 (19.1) | — | — | |
| Time after procedure, years | — | — | — | — | 1.12 (0.10) | 4.18 (0.37) | |
| Laboratory parameters | |||||||
| eGFR, ml/min/1.73 m2 | 74.57 (7.89) | 62.35 (4.19) | 62.14 (2.62) | 58.67 (3.04) | 61.58 (2.03) | 58.74 (2.77) | 0.1078 |
| BUN, mg/dl | 17.14 (1.42) | 25.73 (2.04) | 23.70 (1.29) | 32.04 (2.50) | 24.14 (0.98) | 27.93 (1.00) | 0.0004 |
| Serum creatinine, mg/dl | 1.09 (0.09) | 1.57 (0.26) | 1.28 (0.04) | 1.42 (0.07) | 1.46 (0.7) | 1.58 (0.09) | 0.0601 |
| NT-ProBNP, pg/ml, median (IQR) | 515.2 (423.45) | 966.7 (1,918.00) | 1,542.0 (3,489.80) | 2,969.0 (2,975.75) | 1,265.0 (1,597.60) | 1,203.5 (2,876.88) | <0.0001 |
| Na, mmol/liter | 141.57 (1.19) | 140.38 (0.53) | 140.16 (0.45) | 136.50 (0.64) | 140.09 (0.26) | 141.52 (0.26) | <0.0001 |
| AST, U/liter | 25.00 (6.01) | 27.60 (3.36) | 25.70 (1.86) | 40.07 (8.59) | 26.22 (1.25) | 25.20 (1.21) | 0.0155 |
| ALT, U/liter | 23.29 (5.82) | 27.03 (3.30) | 29.30 (3.47) | 64.04 (19.19) | 21.99 (1.00) | 23.77 (1.32) | <0.0001 |
| Total bilirubin, mg/dl | 0.51 (0.06) | 0.57 (0.08) | 0.68 (0.05) | 0.95 (0.06) | 0.59 (0.03) | 0.55 (0.03) | <0.0001 |
| Echocardiographic parameters | |||||||
| LVEF, % | 26.85 (4.63) | 25.23 (1.21) | 20.05 (0.91) | 16.87 (0.73) | 18.99 (0.83) | 58.94 (0.50) | <0.0001 |
| TR, ≥2+ | 2 (16.7) | 8 (14.5) | 14 (19.2) | 39 (41.5) | 31 (14.8) | 21 (10.5) | <0.0001 |
| RV function (≥moderately reduced) | 2 (16.7) | 15 (27.3) | 26 (35.6) | 66 (70.2) | 81 (38.6) | 9 (4.5) | <0.0001 |
| Medications | |||||||
| ASA | 7 (58.3) | 40 (72.7) | 38 (52.1) | 53 (56.4) | 151 (71.9) | 177 (88.5) | <0.0001 |
| Coumadin | 0 (0) | 4 (7.3) | 18 (24.7) | 8 (8.5) | 187 (89.0) | 5 (2.5) | <0.0001 |
| ACE inhibitors | 4 (33.3) | 20 (26.4) | 20 (27.4) | 3 (3.2) | 59 (28.1) | 11 (5.5) | <0.0001 |
| ARB | 7 (58.3) | 23 (41.8) | 38 (52.1) | 13 (13.8) | 35 (16.7) | 38 (19.0) | <0.0001 |
| Aldosterone antagonists | 7 (58.3) | 30 (54.5) | 49 (67.1) | 55 (58.5) | 81 (38.6) | 3 (1.5) | <0.0001 |
| β-blockers | 12 (100.0) | 54 (98.2) | 66 (90.4) | 53 (56.4) | 188 (89.5) | 37 (18.5) | <0.0001 |
| Statin | 5 (4.2) | 33 (60.0) | 39 (53.4) | 52 (55.3) | 74 (35.3) | 168 (84.0) | <0.0001 |
| Loop diuretics | 7 (58.3) | 37 (67.3) | 62 (84.9) | 68 (72.3) | 141 (67.1) | 40 (20.0) | <0.0001 |
| Digoxin | 2 (16.7) | 7 (12.7) | 22 (30.1) | 16 (17.0) | 73 (34.8) | 0 (0) | <0.0001 |
| Antibioticsb | 0 (0) | 5 (9.1) | 9 (12.3) | 21 (22.3) | 58 (27.6) | 64 (32.0) | 0.0002 |
| Peri-procedural antibioticsc | 0 (0.0) | 0 (0.0) | 5 (6.8) | 34 (36.2) | 3 (1.4) | 0 (0.0) | <0.0001 |
ACE, angiotensin-converting enzyme; ALT, alanine transaminase; ASA, acetylsalicylic acid; AST, aspartate transaminase; ARB, angiotensin receptor blocker; BMI, body mass index; BUN, blood urea nitrogen; eGFR, estimated glomerular filtration rate; HF, heart failure; HT, heart transplantation; INTERMACS, Interagency Registry for Mechanically Assisted Circulatory Support; IQR, interquartile range; LVAD, left ventricular assist device; LVEF, left ventricular ejection fraction; NA, not applicable; NT-proBNP, N-terminal prohormone B-type natriuretic peptide; NYHA, New York Heart Association; RV, right ventricle; TR, tricuspid regurgitation.
Data presented as n (%) or mean (SE) as appropriate, unless otherwise noted.
A total of 452 patients provided a total of 644 blood samples. Repeated measures within LVAD and HT groups are due to longitudinal sampling after LVAD and HT (mean number of samples per patient in the LVAD and HT groups are 1.6 and 1.3).
Antibiotic use is defined as any antibiotic use that was indicated for infection or chronic prophylaxis among post-HT patients and that was estimated to have occurred 1 month before stool collection.
Peri-procedural antibiotic use is defined as antibiotic utilization in relation to cardiac surgery, or for other invasive procedures (e.g., dental interventions).