title: One-Year Clinical Outcome in End-Stage Heart Failure: Comparison of "High Urgent" Listing for Heart Transplantation with Mechanical Circulatory Support Implantation.
abstract: BACKGROUND
  Heart transplantation (HTx) is still considered the therapeutic gold standard in end-stage heart failure.
  
  
  METHODS
  In "high urgent" (HU)-listed patients for HTx (n = 274) and patients receiving left ventricular assist device (LVAD) implants (n = 332), we compared 1-year overall survival (primary endpoint) and 1-year probability of HTx and therapy failure (the need for LVAD implantation in HU-listed patients or the need for HU listing in LVAD patients) (secondary endpoints).
  
  
  RESULTS
  In the HU and LVAD group, 1-year survival was 86.8 and 64.7%, respectively (p < 0.001). The propensity score (PS)-adjusted hazard ratio of mortality did not differ between the groups and for the LVAD group (reference = HU group) was = 1.36 (95% confidence interval [CI]: 0.85-2.19; p = 0.198). The PS-adjusted hazard ratio for the failure to receive HTx for the LVAD group (reference = HU group) was = 9.77 (95% CI: 6.00-15.89; p < 0.001). The corresponding hazard ratio for therapy failure for the LVAD group was = 0.16, 95% CI: 0.10-0.27; p < 0.001).
  
  
  CONCLUSIONS
  Despite considerable differences in the probability of HTx and therapy failure, 1-year overall survival was similar in HU and LVAD patients.
authors.affiliation: Department for Thoracic and Cardiovascular Surgery, Ruhr-University Bochum, Bad Oeynhausen, Germany.
authors.forename: Jakub
authors.initials: J
authors.lastname: Sunavsky
authors.affiliation: Department for Thoracic and Cardiovascular Surgery, Ruhr-University Bochum, Bad Oeynhausen, Germany.
authors.forename: Armin
authors.initials: A
authors.lastname: Zittermann
authors.affiliation: Department for Thoracic and Cardiovascular Surgery, Ruhr-University Bochum, Bad Oeynhausen, Germany.
authors.forename: Cenk
authors.initials: C
authors.lastname: Oezpeker
authors.affiliation: Department for Thoracic and Cardiovascular Surgery, Ruhr-University Bochum, Bad Oeynhausen, Germany.
authors.forename: Buntaro
authors.initials: B
authors.lastname: Fujita
authors.affiliation: Department for Thoracic and Cardiovascular Surgery, Ruhr-University Bochum, Bad Oeynhausen, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Fuchs
authors.affiliation: Department for Thoracic and Cardiovascular Surgery, Ruhr-University Bochum, Bad Oeynhausen, Germany.
authors.forename: Jan F
authors.initials: JF
authors.lastname: Gummert
authors.affiliation: Department for Thoracic and Cardiovascular Surgery, Ruhr-University Bochum, Bad Oeynhausen, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Schulz
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D057216:Propensity Score; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D014850:Waiting Lists / Q000401:mortality