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Predictive capabilities of the European registry for patients with mechanical circulatory support right-sided heart failure risk score after left ventricular assist device implantation.

Publication ,  Journal Article
Nicoara, A; Wright, MC; Rosenkrans, D; Patel, CB; Schroder, JN; Cherry, AD; Hashmi, NK; Pollak, AL; McCartney, SL; Katz, J; Milano, CA; Podgoreanu, MV
Published in: J Cardiothorac Vasc Anesth
October 2022

OBJECTIVES: The prediction of right heart failure (RHF) after left ventricular assist device (LVAD) implantation remains a challenge. Recently, risk scores were derived from analysis of the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) data, the EUROMACS-RHF, and the modified postoperative EUROMACS-RHF. The authors assessed the performance characteristics of these 2 risk score formulations in a continuous-flow LVAD cohort at their institution. DESIGN: A retrospective, observational study. SETTING: At a tertiary-care academic medical center. PARTICIPANTS: Adult patients who underwent durable LVAD implantation between 2015 and 2018. INTERVENTIONS: None MEASUREMENTS AND MAIN RESULTS: Early post-LVAD RHF was defined as follows: (1) need for right ventricular assist device, or (2) inotropic or inhaled pulmonary vasodilator support for ≥14 postoperative days. The authors used logistic regression and examined receiver operating characteristic (ROC) curves to evaluate the ability of the 2 risk scores to distinguish between outcome groups. A total of 207 patients met the inclusion criteria. Of the patients, 16% developed RHF (33/207). The EUROMACS-RHF score was not predictive of RHF in the authors' cohort (odds ratio [OR] 1.25; 95% CI [0.99-1.60]; p = 0.06), but the postoperative EUROMACS-RHF CPB score was significantly associated (OR 1.38; 95% CI [1.03-1.89]; p = 0.03). The scores had similar ROC curves, with weak discriminatory performance: 0.601 (95% CI [0.509-0.692]) and 0.599 (95% CI [0.505-0.693]) for EUROMACS-RHF and postoperative EUROMACS-RHF, respectively. CONCLUSIONS: In the authors' single-center retrospective analysis, the EUROMACS-RHF risk score did not predict early RHF. An optimized risk score for the prediction of RHF after LVAD implantation remains an urgent unmet need.

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Published In

J Cardiothorac Vasc Anesth

DOI

EISSN

1532-8422

Publication Date

October 2022

Volume

36

Issue

10

Start / End Page

3740 / 3746

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Right
  • Treatment Outcome
  • Risk Factors
  • Retrospective Studies
  • Registries
  • Humans
  • Heart-Assist Devices
  • Heart Failure
  • Anesthesiology
  • Adult
 

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Nicoara, A., Wright, M. C., Rosenkrans, D., Patel, C. B., Schroder, J. N., Cherry, A. D., … Podgoreanu, M. V. (2022). Predictive capabilities of the European registry for patients with mechanical circulatory support right-sided heart failure risk score after left ventricular assist device implantation. J Cardiothorac Vasc Anesth, 36(10), 3740–3746. https://doi.org/10.1053/j.jvca.2022.06.022
Nicoara, Alina, Mary Cooter Wright, Daniel Rosenkrans, Chetan B. Patel, Jacob N. Schroder, Anne D. Cherry, Nazish K. Hashmi, et al. “Predictive capabilities of the European registry for patients with mechanical circulatory support right-sided heart failure risk score after left ventricular assist device implantation.J Cardiothorac Vasc Anesth 36, no. 10 (October 2022): 3740–46. https://doi.org/10.1053/j.jvca.2022.06.022.
Nicoara A, Wright MC, Rosenkrans D, Patel CB, Schroder JN, Cherry AD, et al. Predictive capabilities of the European registry for patients with mechanical circulatory support right-sided heart failure risk score after left ventricular assist device implantation. J Cardiothorac Vasc Anesth. 2022 Oct;36(10):3740–6.
Nicoara, Alina, et al. “Predictive capabilities of the European registry for patients with mechanical circulatory support right-sided heart failure risk score after left ventricular assist device implantation.J Cardiothorac Vasc Anesth, vol. 36, no. 10, Oct. 2022, pp. 3740–46. Pubmed, doi:10.1053/j.jvca.2022.06.022.
Nicoara A, Wright MC, Rosenkrans D, Patel CB, Schroder JN, Cherry AD, Hashmi NK, Pollak AL, McCartney SL, Katz J, Milano CA, Podgoreanu MV. Predictive capabilities of the European registry for patients with mechanical circulatory support right-sided heart failure risk score after left ventricular assist device implantation. J Cardiothorac Vasc Anesth. 2022 Oct;36(10):3740–3746.
Journal cover image

Published In

J Cardiothorac Vasc Anesth

DOI

EISSN

1532-8422

Publication Date

October 2022

Volume

36

Issue

10

Start / End Page

3740 / 3746

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Right
  • Treatment Outcome
  • Risk Factors
  • Retrospective Studies
  • Registries
  • Humans
  • Heart-Assist Devices
  • Heart Failure
  • Anesthesiology
  • Adult