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A multicenter evaluation of the HeartMate 3 risk score

Jagpreet Grewal1, Neeta Tripathi2, Ben Bortner1

  • 1Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|December 7, 2023
PubMed

Insights

The Heartmate 3 risk score (HM3RS) accurately predicts mortality in patients receiving the Heartmate 3 left ventricular assist device (LVAD). Its predictive value is reduced in patients not meeting trial criteria.

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.
Abstract

Keywords:
HeartMate 3durable LVADmechanical circulatory supportoutcomesrisk score

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