title: 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.
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.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo.
authors.forename: Takeo
authors.initials: T
authors.lastname: Fujino
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kinugawa
authors.forename: Masaru
authors.initials: M
authors.lastname: Hatano
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Imamura
authors.forename: Hironori
authors.initials: H
authors.lastname: Muraoka
authors.forename: Shun
authors.initials: S
authors.lastname: Minatsuki
authors.forename: Toshiro
authors.initials: T
authors.lastname: Inaba
authors.forename: Hisataka
authors.initials: H
authors.lastname: Maki
authors.forename: Osamu
authors.initials: O
authors.lastname: Kinoshita
authors.forename: Kan
authors.initials: K
authors.lastname: Nawata
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yao
authors.forename: Minoru
authors.initials: M
authors.lastname: Ono
authors.forename: Issei
authors.initials: I
authors.lastname: Komuro