Anemia and outcomes following left ventricular assist device implantation

Artif Organs. 2022 Aug;46(8):1626-1635. doi: 10.1111/aor.14224. Epub 2022 Mar 4.

Abstract

Background: Patients with concomitant anemia and congestive heart failure have poor outcomes. The prevalence and clinical risk of anemia in patients receiving durable left ventricular assist devices (LVAD) remain unknown.

Methods: We retrospectively analyzed patients who underwent LVAD implantation between 2014 and 2018. The association between hemoglobin level at the time of index discharge and the one-year composite endpoint of heart failure readmissions or hemocompatibility-related adverse events was investigated.

Results: A total of 168 patients (57 [48, 66] years old, 123 males) were included and stratified into a classification of anemia (hemoglobin <9.7 g/dl, N = 99) or non-anemia (N = 69). The anemia group had a higher one-year incidence of the composite endpoint (56% vs 36%, p = .013) with an adjusted hazard ratio of 1.83 (95% confidence interval 1.08-2.82). Patients with anemia also experienced suboptimal bi-ventricular unloading.

Conclusions: Anemia was prevalent in LVAD patients and associated with a greater risk of heart failure and hemocompatibility-related adverse events. The optimal threshold for therapeutic intervention in response to post-LVAD anemia needs further investigation.

Keywords: heart failure; hemocompatibility; hemodynamics; mechanical circulatory support.

Publication types

  • Review

MeSH terms

  • Aged
  • Heart Failure* / complications
  • Heart Failure* / epidemiology
  • Heart Failure* / surgery
  • Heart Ventricles
  • Heart-Assist Devices* / adverse effects
  • Humans
  • Male
  • Retrospective Studies
  • Treatment Outcome