Validation of the HeartMate 3 survival risk score in a large left ventricular assist device center

被引：0

作者：

Moeller, Cathrine M. ^{[1
]}

Rubinstein, Gal ^{[1
]}

Oren, Daniel ^{[1
]}

Valledor, Andrea Fernandez ^{[1
]}

Lotan, Dor ^{[1
]}

Raikhelkar, Jayant K. ^{[1
]}

Clerkin, Kevin J. ^{[1
]}

Colombo, Paolo C. ^{[1
]}

Leahy, Nicole E. ^{[1
]}

Fried, Justin A. ^{[1
]}

Kaku, Yuji ^{[2
]}

Naka, Yoshifumi ^{[2
]}

Takeda, Koji ^{[2
]}

Yuzefpolskaya, Melana ^{[1
]}

Topkara, Veli K. ^{[1
]}

Sayer, Gabriel T. ^{[1
]}

Uriel, Nir ^{[1
]}

机构：

[1] Columbia Univ, Irving Med Ctr, Dept Med, Div Cardiol, New York, NY USA

[2] Columbia Univ, Irving Med Ctr, Dept Cardiothorac Surg, New York, NY USA

来源：

JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY | 2025年 / 169卷 / 02期

关键词：

HeartMate; 3; HeartMate 3 survival risk score; left ventricular assist device; prediction; validation;

D O I：

10.1016/j.jtcvs.2024.03.009

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: The HeartMate 3 survival risk score was recently validated in the Multicenter study Of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy with HeartMate 3 to predict patient-specific survival in HeartMate 3 left ventricular assist device candidates. The HeartMate 3 survival risk score stratifies individuals into tertiles according to survival probability. Methods: We performed a single-center retrospective review of all HeartMate 3 left ventricular assist device recipients between September 2017 and August 2022. Baseline characteristics were collected from the electronic medical records. HeartMate 3 survival risk scores were calculated for all eligible patients. One- and 2-year Kaplan-Meier survival analyses were conducted. A univariate and multivariable Cox regression model was used to identify predictors. Results: A total of 181 patients were included in this fi nal analysis. The median age was 62 years, 83% were male, and 26% were Interagency Registry for Mechanically Assisted Circulatory Support Profile 1. The mean HeartMate 3 survival risk score for the entire cohort was 2.66 +/- 0.66. Two-year survivals in the high, average, and low survival groups were 93.5% +/- 3.2%, 81.6% +/- 7.4%, and 82.0% +/- 6.6%, respectively. As a continuous variable, the unadjusted HeartMate 3 survival risk score was a significant predictor of mortality (hazard ratio, 2.20; 95% CI, 1.08-4.45; P = .029). The areas under the curve were 0.70 and 0.66 at 1 and 2 years, respectively. We were unable to demonstrate the discriminatory ability of the HeartMate 3 survival risk score using the original stratification, but we found significantly increased survival in the high survival group using a binary cutoff (hazard ratio, 4.8; 95% CI, 1.0120.9; P = .038). Conclusions: The unadjusted HeartMate 3 survival risk score was associated with postimplant survival in patients outside of the Multicenter study Of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy with HeartMate 3 but did not remain an independent predictor after adjusting for ischemic etiology and severe diabetes. The HeartMate 3 survival risk score was able to identify patients at high survival using a binary cutoff, but we were unable to demonstrate its discriminatory ability among the previously published risk tertiles.

引用

页码：650 / 657.e4

页数：12

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