Introduction:
Obesity is a major risk factor for cardiovascular outcomes and it is prevalent in patients (pts) with advanced heart failure requiring left ventricular assist devices (LVAD). The understanding of high body mass index (BMI) after LVAD implantation outcomes continues to evolve. In this study, we investigated the effects of obesity on post-LVAD re-hospitalization.
Methods:
In this retrospective study, 288 pts with both HeartMate II and HeartWare HVAD, implanted for bridge to transplantation (BTT) and destination therapy (DT), were enrolled. Pts were stratified based on a BMI ≥ 30. Baseline demographics were obtained. Post LVAD incidence of readmissions and major adverse effects were tabulated.
Results:
The cohort was comprised of 95 (33%) obese and 193 (67%) non-obese pts, (63 (25%) women vs 225 (75%) men), BTT 48 (20%), vs DT 240(80%). The mean BMI in the obese group was 35.2 Kg/M2 compared to 24.3 Kg/M2 (p=<0.001) in the control group. There were no differences in the index length of stay and time to readmissions between the two groups. However, obese pts had a higher mean total number of hospitalizations compared to non-obese pts (4.2 vs. 3.4, p=0.03). Other than the incidence of post-LVAD heart failure and hemolysis being higher in the obese group, there were no other statistically significant differences between the two groups (Table 1). There was a trend towards higher thrombosis in the obese cohort.
Conclusions:
Obese pts had a higher number of total hospitalizations compared to non-obese pts. There was no difference in time to readmission between the groups. These readmissions appear to be mainly driven by heart failure and hemolysis. Further investigation to determine causality is indicated.
Increased Risk of Gastrointestinal Bleeding in HeartMate II Compared to HeartWare Left Ventricular Assist Devices - A Single Center Retrospective Cohort
