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Updated: Jun 23, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
06:10

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

Clinical impact of guideline-directed medical therapy in patients with left ventricular assist device: an

Miloud Cherbi1, Clément Delmas2, Paul Gautier2

  • 1Department of Cardiology, AZ Sint-Jan Hospital, Ruddershove 10, 8000 Bruges, Belgium.

ESC Heart Failure
|June 22, 2026
PubMed

Insights

Guideline-directed medical therapy (GDMT) significantly improves survival and reduces ventricular arrhythmias in left ventricular assist device (LVAD) patients. However, less than 30% of patients receive optimal triple therapy, indicating a need for better implementation strategies.

Area of Science:

  • Cardiology
  • Medical Devices
  • Pharmacology

Background:

  • Guideline-directed medical therapy (GDMT) is recommended for left ventricular assist device (LVAD) recipients.
  • Real-world evidence on GDMT's clinical impact in LVAD patients is limited.

Purpose of the Study:

  • To evaluate the association between GDMT prescription and clinical outcomes in LVAD patients.
  • To assess the impact of GDMT on survival and ventricular arrhythmias in LVAD recipients.

Main Methods:

  • International retrospective multicenter study of 875 LVAD patients.
  • Patients categorized by GDMT (ACE-I/ARBs, beta-blockers, MRAs) prescription.
  • Primary outcome: 6-month all-cause mortality; Secondary outcome: late ventricular arrhythmias (VAs).

Main Results:

  • Only 29.8% of patients received triple GDMT; 11.1% received none.
  • Increased GDMT prescription associated with significantly improved survival (aHRs 0.39-0.51) and reduced VAs (aHR 0.65).
  • Triple GDMT correlated with greater left ventricular end-diastolic diameter improvement (66.1% vs 51.5%).

Conclusions:

  • GDMT use in LVAD patients is linked to better survival, with benefits seen even with single-agent therapy.
  • Suboptimal triple therapy prescription (30%) highlights the need for improved implementation and standardized protocols.
  • Further research should focus on optimizing GDMT strategies for LVAD recipients.
Abstract

Keywords:
Guideline-directed medical therapyHeartmateHeartwareLeft ventricular assist deviceVentricular arrhythmia

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