Comparison of In-Hospital Outcomes of Patients With-Versus-Without Ischemic Cardiomyopathy Undergoing Left Ventricular Assist Device Placement

The objective of this study was to evaluate the impact of heart failure (HF) etiology (ischemic cardiomyopathy [ICM] versus nonischemic cardiomyopathy) on in-hospital outcomes in patients undergoing left ventricular assist device (LVAD) placement using the Nationwide Inpatient Sample database. We identified patients who underwent LVAD placement from 2011 to 2014. The primary end point was the effect of ICM on in-hospital mortality. Secondary end points included periprocedural vascular complications requiring surgery, postoperative myocardial infarction, stroke, and hemorrhage requiring transfusion. We also assessed length of stay and cost of hospitalization. A mixed effects logistic model was used for clinical end points and a linear mixed model was used for cost and length of stay. In 3,511 patients who underwent LVAD placement (23.32% women and 56.23 ± 13.51 years old), the incidence of ICM was 53.5%. After adjusting for patient- and hospital-level characteristics, ICM was not found to influence in-hospital mortality (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.78 to 1.23). ICM was associated with an increased risk in periprocedural hemorrhage requiring transfusion (OR 1.29, 95% CI 1.08 to 1.53), vascular complications requiring surgery (OR 1.58 95% CI 1.10 to 2.28) and postoperative ST-segment myocardial infarction (OR 7.38 95% CI 5.33 to 10.24). In conclusion, ICM did not impact in-hospital mortality in patients who underwent LVAD placement but was associated with increased vascular complications, hemorrhage requiring transfusion, and postoperative myocardial infarction.