title: Racial differences in patients with left ventricular assist devices.
abstract: We examined clinical outcomes based on ethnicity in patients undergoing left ventricular assist device (LVAD) implantation. We hypothesized that treatment in a specialized, comprehensive heart failure program results in similar survival between African Americans and whites. We retrospectively reviewed patient data implanted with HeartMate II (HM-II) LVAD over 2 years. There were 79 patients: 34 (43%) whites, 33 (42%) African Americans, and 12 (15%) patients belonging to other ethnicities there was no difference in demographics. The etiology of cardiomyopathy was more commonly ischemic in white patients compared to nonischemic in African American patients (p = 0.01). The mean left ventricular ejection fraction was 22.21 ± 10.66% in African American patients and 15.21 ± 5.54% in white patients (p = 0.008). The left ventricular end-diastolic (p = 0.06) and end-systolic (p = 0.03) diameters were greater in white patients compared to African American patients. Hypertension was seen in 79% of African American patients compared to 56% in white patients (p = 0.07). Survival by Kaplan-Meier analysis revealed an unadjusted survival advantage in African American patients (p = 0.04 by log-rank test), but this survival advantage was lost in multivariable Cox regression analysis after adjustment for other covariates. There was no difference in readmissions (p = 0.36). In patients with advanced heart failure undergoing HM-II LVAD implantation, African American patients had a similar survival and no difference in readmissions when compared with white patients despite significant differences in baseline clinical characteristics.
authors.affiliation: Center for Heart Transplant and Assist Devices, Advocate Christ Medical Center, Oak Lawn, Illinois 60453, USA.
authors.forename: Ashim
authors.initials: A
authors.lastname: Aggarwal
authors.forename: Ankit
authors.initials: A
authors.lastname: Gupta
authors.forename: Pat S
authors.initials: PS
authors.lastname: Pappas
authors.forename: Antone
authors.initials: A
authors.lastname: Tatooles
authors.forename: Geetha
authors.initials: G
authors.lastname: Bhat
mesh_terms: D001741:Black or African American; D004452:Echocardiography; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D006353:Heart-Assist Devices; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D012189:Retrospective Studies; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D044465:White People