Assessing The Outcomes In Black Women Patients Following Left Ventricular Assist Device Implantation: Representation Through A Single Center Analysis.

Black women have been underrepresented in left ventricular assist device (LVAD) clinical trials and published reports. The aim of this study was to examine the outcomes of Black women undergoing LVAD implantation. We retrospectively identified Black women who underwent LVAD implantation at a single center between January 1, 2007 and October 31, 2020. Outcomes of patients who received HeartMate II (HMII), HeartWare (HVAD), and HeartMate 3 (HM3) devices were compared. Adverse events (AEs) for all patients were calculated as events per patient-year (EPPY). Reasons for readmissions, including incidence and rates, were reviewed. A total of 154 Black female patients underwent LVAD implantation during the study period. Sixty-six received HVAD, 36 received HMII, and 52 received HM3 devices (Figure 1). Median age for all patients was 57.7 years (IQR 46.9-64). At baseline, patients supported with HMII and HM3 were more likely to have diabetes compared to those supported with HVAD (HM3 50% vs HMII 50% vs HVAD 22.7%, p=0.003). HM3 recipients had a higher incidence of stroke pre-operatively (17.3% vs HMII 13.9% vs HVAD 3%, p=0.03). Post-operatively, HM3 recipients were on inotropes for longer duration (14 days vs HMII 9 days vs HVAD 8.5 days (IQR 5.3-16), p=0.004) and were placed on Epoprostenol at higher frequency (65.4% vs HMII 27.8% vs HVAD 39.4%, p=0.001). In regards to AEs, the incidence of LVAD-related infections was 25.3%, gastrointestinal bleeding was 33.8%, and cerebrovascular accidents was 14.3%. Twenty-nine pump thrombosis events occurred in 20 (13%) patients. Overall, patients supported with HM3 demonstrated lower rates of pump thrombosis (EPPY: 0.008 vs HMII 0.216 vs HVAD 0.062, p<0.001 and p=0.034, respectively)(Figure 1). HM3 patients experienced fewer readmissions for LVAD infection compared to HMII patients (EPPY: 0.19 vs HMII 0.49, p=0.001) as well as for cardiac arrhythmias (EPPY: 0.07 vs HMII 0.26, p=0.003). Hospitalization for LVAD alarms was significantly higher in the HM3 population (44% vs. HMII 19.4%, p<0.001). Black Women LVAD recipients experienced differential outcomes post-LVAD by device type including rates of pump thrombosis, infection, and hospitalization for LVAD alarms. Additional studies are warranted to further examine racial and sex disparities in pre- and post-LVAD clinical outcomes. [ABSTRACT FROM AUTHOR]