Ischemic Cardiomyopathy is Associated with Increased Hemocompatibility Related Adverse Events Compared to Non-Ischemic Cardiomyopathy in LVAD Patients

Purpose Hemocompatibility Related Adverse Events (HRAE) remain a significant cause of morbidity and mortality in LVAD patients. The association between device specific factors and HRAE has been studied, however less is known about patient specific factors. The aim of this study was to investigate the influence of the etiology of heart failure on HRAE. Methods Retrospective single center chart review of all patients who underwent LVAD implantation from 3/2014 to 8/2018 was performed. The etiology of heart failure was classified as Ischemic Cardiomyopathy (ICM) or Non Ischemic Cardiomyopathy (NICM). An age matched cohort was analyzed using propensity score matching. Results 50 patients with ICM (age 61 yrs ± 11, 73% male) were compared to 49 patients with NICM (age 60 yrs ± 10, 76% male). There was no significant difference in heart failure free survival at 2 years(ICM= 50.2% vs NICM 58.3%,p=0.39) or all-cause mortality(ICM=25.8% vs NICM 27.7%,p=0.69) between the two groups. There was a statistically significant increase in HRAE -free survival in patients with NICM(61.9%) compared to ICM (25.5%) at 2 years(p=0.006) (Figure 1) Conclusion ICM is a risk factor for increased HRAE compared to NICM. Further studies are needed to ascertain whether these patients may benefit with different management strategies to avoid HRAE.