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A Device Strategy-Matched Comparison Analysis among Different Intermacs Profiles: A Single Center Experience
Background: The present study evaluates outcomes of LVAD patients, taking into account the device strategy and the INTERMACS profile. Methods: We included 192 LVAD-patients implanted between January 2012 and May 2021. The primary and secondary end-points were survival and major adverse events betwee...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410490/ https://www.ncbi.nlm.nih.gov/pubmed/36013140 http://dx.doi.org/10.3390/jcm11164901 |
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author | Caraffa, Raphael Bejko, Jonida Carrozzini, Massimiliano Bifulco, Olimpia Tarzia, Vincenzo Lorenzoni, Giulia Bottigliengo, Daniele Gregori, Dario Castellani, Chiara Bottio, Tomaso Angelini, Annalisa Gerosa, Gino |
author_facet | Caraffa, Raphael Bejko, Jonida Carrozzini, Massimiliano Bifulco, Olimpia Tarzia, Vincenzo Lorenzoni, Giulia Bottigliengo, Daniele Gregori, Dario Castellani, Chiara Bottio, Tomaso Angelini, Annalisa Gerosa, Gino |
author_sort | Caraffa, Raphael |
collection | PubMed |
description | Background: The present study evaluates outcomes of LVAD patients, taking into account the device strategy and the INTERMACS profile. Methods: We included 192 LVAD-patients implanted between January 2012 and May 2021. The primary and secondary end-points were survival and major adverse events between Profiles 1–3 vs. Profile 4, depending on implantation strategies (Bridge-to-transplant-BTT; Bridge-to-candidacy-BTC; Destination-Therapy-DT). Results: The overall survival was 67% (61–75) at 12 months and 61% (54–70) at 24 months. Profile 4 patients showed significantly higher survival (p = 0.018). Incidences of acute right-ventricular-failure (RVF) (p = 0.046), right-ventricular-assist-device (RVAD) implantation (p = 0.015), and continuous-venovenous-hemofiltration (CVVH) (p = 0.006) were higher in Profile 1–3 patients, as well as a longer intensive care unit stays (p = 0.050) and in-hospital-mortality (p = 0.012). Twelve-month and 24-month survival rates were higher in the BTT rather than in BTC (log-rank = 0.410; log-rank = 0.120) and in DT groups (log-rank = 0.046). In the BTT group, Profile 1–3 patients had a higher need for RVAD support (p = 0.042). Conclusions: LVAD implantation in elective patients was associated with better survival and lower complications incidence. LVAD implantation in BTC patients has to be considered before their conditions deteriorate. DT should be addressed to elective patients in order to guarantee acceptable results. |
format | Online Article Text |
id | pubmed-9410490 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-94104902022-08-26 A Device Strategy-Matched Comparison Analysis among Different Intermacs Profiles: A Single Center Experience Caraffa, Raphael Bejko, Jonida Carrozzini, Massimiliano Bifulco, Olimpia Tarzia, Vincenzo Lorenzoni, Giulia Bottigliengo, Daniele Gregori, Dario Castellani, Chiara Bottio, Tomaso Angelini, Annalisa Gerosa, Gino J Clin Med Article Background: The present study evaluates outcomes of LVAD patients, taking into account the device strategy and the INTERMACS profile. Methods: We included 192 LVAD-patients implanted between January 2012 and May 2021. The primary and secondary end-points were survival and major adverse events between Profiles 1–3 vs. Profile 4, depending on implantation strategies (Bridge-to-transplant-BTT; Bridge-to-candidacy-BTC; Destination-Therapy-DT). Results: The overall survival was 67% (61–75) at 12 months and 61% (54–70) at 24 months. Profile 4 patients showed significantly higher survival (p = 0.018). Incidences of acute right-ventricular-failure (RVF) (p = 0.046), right-ventricular-assist-device (RVAD) implantation (p = 0.015), and continuous-venovenous-hemofiltration (CVVH) (p = 0.006) were higher in Profile 1–3 patients, as well as a longer intensive care unit stays (p = 0.050) and in-hospital-mortality (p = 0.012). Twelve-month and 24-month survival rates were higher in the BTT rather than in BTC (log-rank = 0.410; log-rank = 0.120) and in DT groups (log-rank = 0.046). In the BTT group, Profile 1–3 patients had a higher need for RVAD support (p = 0.042). Conclusions: LVAD implantation in elective patients was associated with better survival and lower complications incidence. LVAD implantation in BTC patients has to be considered before their conditions deteriorate. DT should be addressed to elective patients in order to guarantee acceptable results. MDPI 2022-08-20 /pmc/articles/PMC9410490/ /pubmed/36013140 http://dx.doi.org/10.3390/jcm11164901 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Caraffa, Raphael Bejko, Jonida Carrozzini, Massimiliano Bifulco, Olimpia Tarzia, Vincenzo Lorenzoni, Giulia Bottigliengo, Daniele Gregori, Dario Castellani, Chiara Bottio, Tomaso Angelini, Annalisa Gerosa, Gino A Device Strategy-Matched Comparison Analysis among Different Intermacs Profiles: A Single Center Experience |
title | A Device Strategy-Matched Comparison Analysis among Different Intermacs Profiles: A Single Center Experience |
title_full | A Device Strategy-Matched Comparison Analysis among Different Intermacs Profiles: A Single Center Experience |
title_fullStr | A Device Strategy-Matched Comparison Analysis among Different Intermacs Profiles: A Single Center Experience |
title_full_unstemmed | A Device Strategy-Matched Comparison Analysis among Different Intermacs Profiles: A Single Center Experience |
title_short | A Device Strategy-Matched Comparison Analysis among Different Intermacs Profiles: A Single Center Experience |
title_sort | device strategy-matched comparison analysis among different intermacs profiles: a single center experience |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410490/ https://www.ncbi.nlm.nih.gov/pubmed/36013140 http://dx.doi.org/10.3390/jcm11164901 |
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