A multicenter evaluation of the HeartMate 3 risk score

Area of Science:

• Cardiology
• Medical Devices
• Clinical Trials

Background:

• The Heartmate 3 risk score (HM3RS) was developed using data from the MOMENTUM 3 trial.
• It predicts 1- and 2-year mortality risk in patients before Heartmate 3 left ventricular assist device (LVAD) implantation.

Purpose of the Study:

• To evaluate the performance of the HM3RS in a real-world, unselected patient population.
• To assess HM3RS accuracy in patients who did not meet the inclusion criteria for the MOMENTUM 3 trial.

Main Methods:

• Retrospective analysis of 521 patients who underwent HM3 LVAD implantation between 2017 and 2021.
• Patients were assessed for eligibility for the MOMENTUM 3 trial.
• Time-dependent receiver operating characteristic curve analysis was used to evaluate HM3RS risk discrimination for 1-year mortality.

Main Results:

• Overall 1- and 2-year survival rates were 85% and 81%, respectively.
• Survival rates did not significantly differ between patients who met and did not meet MOMENTUM 3 trial eligibility criteria.
• HM3RS showed adequate risk discrimination for the total cohort (AUC 0.63), performing better in patients meeting trial criteria (AUC 0.69) than those who did not (AUC 0.58).

Conclusions:

• Excellent 1- and 2-year survival was observed in patients receiving the HM3 LVAD, irrespective of trial eligibility.
• The HM3RS demonstrated adequate predictive value in patients similar to those in the MOMENTUM 3 trial.
• The predictive accuracy of HM3RS was diminished in patients who did not meet the original trial's inclusion criteria.