Low Blood Pressure, Low Serum Cholesterol and Anemia Predict Early Necessity of Ventricular Assist Device Implantation in Patients With Advanced Heart Failure at the Time of Referral From Non-Ventricular Assist Device Institutes

Takeo Fujino; Koichiro Kinugawa; Masaru Hatano; Teruhiko Imamura; Hironori Muraoka; Shun Minatsuki; Toshiro Inaba; Hisataka Maki; Osamu Kinoshita; Kan Nawata; Atsushi Yao; Minoru Ono; Issei Komuro

doi:10.1253/circj.CJ-14-0749

Heart Failure

Low Blood Pressure, Low Serum Cholesterol and Anemia Predict Early Necessity of Ventricular Assist Device Implantation in Patients With Advanced Heart Failure at the Time of Referral From Non-Ventricular Assist Device Institutes

Takeo Fujino, Koichiro Kinugawa, Masaru Hatano, Teruhiko Imamura, Hironori Muraoka, Shun Minatsuki, Toshiro Inaba, Hisataka Maki, Osamu Kinoshita, Kan Nawata, Atsushi Yao, Minoru Ono, Issei Komuro

Author information

Takeo Fujino
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Koichiro Kinugawa
Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo
Masaru Hatano
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Teruhiko Imamura
Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo
Hironori Muraoka
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Shun Minatsuki
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Toshiro Inaba
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Hisataka Maki
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Osamu Kinoshita
Department of Cardiothoracic Surgery, Graduate School of Medicine, University of Tokyo
Kan Nawata
Department of Cardiothoracic Surgery, Graduate School of Medicine, University of Tokyo
Atsushi Yao
Division for Health Service Promotion, University of Tokyo
Minoru Ono
Department of Cardiothoracic Surgery, Graduate School of Medicine, University of Tokyo
Issei Komuro
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo

Keywords: INTERMACS profile, Seattle Heart Failure Model, Stage D heart failure

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Supplementary material

2014 Volume 78 Issue 12 Pages 2882-2889

DOI https://doi.org/10.1253/circj.CJ-14-0749

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Abstract

Background:The timing of ventricular assist device (VAD) implantation is always a matter of debate, especially when a patient is referred from a non-VAD institute. We focused on objective noninvasive parameters at the time of admission to a VAD implant center and analyzed the factors predicting the necessity of early VAD.Methods and Results:We retrospectively analyzed advanced heart failure (HF) patients referred since January 2011, including patients less than 65 years old. They all had a history of hospitalization for HF management in non-VAD institutes within 1 month before referral. We excluded patients transferred with mechanical circulatory support. We enrolled 46 patients (40 males, 39.8±13.4 years old). Among them, 26 patients had a VAD implanted or died within 120 days. By multivariable logistic analysis using admission parameters, systolic blood pressure (BP) <93 mmHg [odds ratio (OR) 13.335], hemoglobin <12.7 g/dl (OR 12.175) and serum total cholesterol <144 mg/dl (OR 8.096) were significant predictors of early VAD requirement. We constructed a scoring system according to the ORs, and the area under the receiver-operating characteristic curve was 0.913.Conclusions:Low BP, low serum cholesterol and anemia on admission predict early VAD in advanced HF patients who have been treated in non-VAD institutes. Such patients should be promptly referred to a VAD implant center. (Circ J 2014; 78: 2882–2889)

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