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Anemia and outcomes following left ventricular assist device implantation

Teruhiko Imamura1,2, Nikhil Narang2,3, Stephanie Besser2

  • 1Second Department of Internal Medicine, University of Toyama, Toyama, Japan.

Artificial Organs
|March 1, 2022
PubMed

Insights

Anemia is common in patients with left ventricular assist devices (LVAD) and increases their risk of heart failure readmissions and adverse events. Further research is needed to determine the best treatment for anemia after LVAD implantation.

Area of Science:

  • Cardiology
  • Hematology
  • Medical Devices

Background:

  • Concomitant anemia and congestive heart failure are associated with poor patient outcomes.
  • The prevalence and clinical risks of anemia in patients with durable left ventricular assist devices (LVAD) are not well understood.

Purpose of the Study:

  • To investigate the prevalence of anemia in patients receiving LVADs.
  • To determine the association between hemoglobin levels at discharge and one-year adverse events in LVAD patients.

Main Methods:

  • Retrospective analysis of 168 patients who underwent LVAD implantation from 2014 to 2018.
  • Stratification of patients into anemia (hemoglobin <9.7 g/dL) and non-anemia groups.
  • Investigation of the association between discharge hemoglobin and a composite endpoint of heart failure readmissions or hemocompatibility-related adverse events within one year.

Main Results:

  • Anemia was prevalent, affecting 99 out of 168 patients.
  • The anemia group showed a significantly higher one-year incidence of the composite endpoint (56% vs. 36%, p=0.013).
  • Anemia was associated with an adjusted hazard ratio of 1.83 for adverse events and suboptimal bi-ventricular unloading.

Conclusions:

  • Anemia is a common comorbidity in LVAD patients.
  • Post-LVAD anemia is linked to increased risks of heart failure and hemocompatibility issues.
  • Optimal therapeutic thresholds for post-LVAD anemia require further investigation.
Abstract

Keywords:
heart failurehemocompatibilityhemodynamicsmechanical circulatory support

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