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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
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Sex differences in eligibility for advanced heart failure therapies
Rebecca S Steinberg1, Aditi Nayak1, Celena O'Connell2
1Division of Cardiology, Emory University, Atlanta, Georgia.
Clinical Transplantation
|February 20, 2020
Summary
Women face disparities in advanced heart failure (HF) therapy. They are less likely to be listed for heart transplant (HT) but more likely to receive a left ventricular assist device (LVAD).
Area of Science:
- Cardiology
- Transplantation Medicine
- Medical Devices
Background:
- Women experience higher mortality rates from heart failure (HF) compared to men.
- Existing data indicate lower rates of heart transplant (HT) and left ventricular assist device (LVAD) utilization in women for unclear reasons.
Purpose of the Study:
- To investigate sex-based differences in eligibility for and outcomes of advanced heart failure (HF) therapies.
- To identify factors contributing to disparities in advanced HF treatment for women.
Main Methods:
- A retrospective cohort study of 569 patients evaluated for advanced HF therapies between 2012 and 2016.
- Logistic regression analysis to assess the association between sex and HT/LVAD eligibility.
- Competing risks and Kaplan-Meier analyses to evaluate survival differences.
Main Results:
- Women constituted 31% of the evaluated patients.
- Women were significantly less likely to be listed for HT (adjusted OR 0.36) due to factors like allosensitization and obesity.
- Women were more likely to receive a destination therapy LVAD (adjusted OR 2.29).
Conclusions:
- Women are less likely to be candidates for heart transplantation.
- Women demonstrate a higher likelihood of receiving destination therapy left ventricular assist devices.
- Survival rates were comparable between sexes across different advanced HF therapy pathways.
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