Skip to main content

INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) Profiling Identifies Ambulatory Patients at High Risk on Medical Therapy After Hospitalizations for Heart Failure.

Publication ,  Journal Article
Stewart, GC; Kittleson, MM; Patel, PC; Cowger, JA; Patel, CB; Mountis, MM; Johnson, FL; Guglin, ME; Rame, JE; Teuteberg, JJ; Stevenson, LW
Published in: Circ Heart Fail
November 2016

BACKGROUND: INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) profiles provide important prognostic information for patients with advanced heart failure (HF) receiving mechanical support. The value of INTERMACS profiling has not been shown for patients followed on medical therapy for advanced HF at centers that also offer mechanical circulatory support. METHODS AND RESULTS: This prospective, observational study enrolled 166 patients with chronic New York Heart Association class III-IV HF, ejection fraction ≤30%, and ≥1 HF hospitalization in the previous year, excluding patients listed for transplant or receiving chronic intravenous inotropic therapy. Subjects were followed for at least 12 months or until death, mechanical support, or transplant. Baseline features, quality of life, and outcomes were compared according to INTERMACS profile. Mean age was 57 years, ejection fraction 18%, and 57% had HF >5 years, whereas 23% of subjects were INTERMACS profile 4, 32% profile 5, and 45% profile 6/7. At 1 year, only 47% of this ambulatory advanced HF cohort remained alive on medical therapy. Patients in INTERMACS profile 4 were more likely to die or require mechanical support, with only 52% of these patients alive without support after the first 6 months. Profile 6/7 patients had 1-year survival of 84%, similar to outcomes for contemporary destination left ventricular assist device recipients. Quality of life using the indexed EuroQol score was poor across profiles 4 to 7, although severe limitation was less common than for ambulatory patients enrolled in INTERMACS before ventricular assist device implantation. CONCLUSIONS: Ambulatory patients with systolic HF, a heavy symptom burden, and at least 1 recent HF hospitalization are at high risk for death or left ventricular assist device rescue. INTERMACS profiles help identify ambulatory patients with advanced HF who may benefit from current mechanical support devices under existing indications.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

November 2016

Volume

9

Issue

11

Location

United States

Related Subject Headings

  • Vasodilator Agents
  • Stroke Volume
  • Sodium Potassium Chloride Symporter Inhibitors
  • Severity of Illness Index
  • Risk Assessment
  • Registries
  • Quality of Life
  • Prospective Studies
  • Prognosis
  • Outpatients
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Stewart, G. C., Kittleson, M. M., Patel, P. C., Cowger, J. A., Patel, C. B., Mountis, M. M., … Stevenson, L. W. (2016). INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) Profiling Identifies Ambulatory Patients at High Risk on Medical Therapy After Hospitalizations for Heart Failure. Circ Heart Fail, 9(11). https://doi.org/10.1161/CIRCHEARTFAILURE.116.003032
Stewart, Garrick C., Michelle M. Kittleson, Parag C. Patel, Jennifer A. Cowger, Chetan B. Patel, Maria M. Mountis, Frances L. Johnson, et al. “INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) Profiling Identifies Ambulatory Patients at High Risk on Medical Therapy After Hospitalizations for Heart Failure.Circ Heart Fail 9, no. 11 (November 2016). https://doi.org/10.1161/CIRCHEARTFAILURE.116.003032.
Stewart GC, Kittleson MM, Patel PC, Cowger JA, Patel CB, Mountis MM, Johnson FL, Guglin ME, Rame JE, Teuteberg JJ, Stevenson LW. INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) Profiling Identifies Ambulatory Patients at High Risk on Medical Therapy After Hospitalizations for Heart Failure. Circ Heart Fail. 2016 Nov;9(11).

Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

November 2016

Volume

9

Issue

11

Location

United States

Related Subject Headings

  • Vasodilator Agents
  • Stroke Volume
  • Sodium Potassium Chloride Symporter Inhibitors
  • Severity of Illness Index
  • Risk Assessment
  • Registries
  • Quality of Life
  • Prospective Studies
  • Prognosis
  • Outpatients