Risk Factors of Stroke After Left Ventricular Assist Device Implantation: A Systematic Review and Meta-Analysis

Area of Science:

• Cardiology
• Neurology
• Medical Devices

Background:

• Stroke is a significant cause of death and disability in patients with left ventricular assist devices (LVADs).
• Existing research has identified some risk factors for post-LVAD stroke, but a comprehensive, quantitative analysis is lacking.

Purpose of the Study:

• To systematically identify and quantify risk factors associated with stroke in patients following LVAD implantation.
• To provide evidence for improved clinical decision-making in device selection and targeted interventions to mitigate stroke risk.

Main Methods:

• A systematic literature search was conducted using PubMed and Web of Science to identify relevant studies.
• Risk factors were quantified using standardized mean differences (SMDs) and odds ratios (ORs).
• Subgroup, sensitivity, and publication bias analyses were performed for robust findings.

Main Results:

• Pump thrombosis (OR, 3.26) and infection (OR, 2.44) were the most significant risk factors for post-LVAD stroke.
• Atrial fibrillation was not associated with increased stroke risk (OR, 0.93).
• Other identified risk factors include white race, cancer, COPD, age, albumin levels, diabetes, peripheral vascular disease, and INR.

Conclusions:

• This study quantifies key risk factors for post-LVAD stroke, including pump thrombosis and infection.
• Findings highlight evolving risk profiles in the era of newer LVAD technology.
• The results support personalized interventions to reduce stroke risk in LVAD patients.