Abstract 19925: Novel pre-implant characteristics associated with 12 month risk of gastrointestinal bleeding among patients supported with continuous flow left ventricular assist device therapy
Shi Y, Rappelt M, Yousefzai R, et al. Abstract 19925: Novel pre-implant characteristics associated with 12 month risk of gastrointestinal bleeding among patients supported with continuous flow left ventricular assist device therapy. Circulation. 2015; 132(Suppl 3):A19925.
Introduction: Continuous-flow Left Ventricular Assisted Device (CF-LVAD) therapy is increasingly utilized for patients with end stage heart failure. Among the most common and unpredictable complications after CF-LVAD is gastrointestinal bleeding (GIB).
Hypothesis: We hypothesize that pre-implant characteristics are associated with GIB post-implant of a CF-LVAD. The aim of this analysis is to identify novel pre-implant factors that influence risk of post-implant GIB.
Methods: All CF-LVAD implants between January 2006 and December 2014 among patients who survived more than 15 days were included and followed for 12 months. Primary event was GIB and patients were censored at time of re-implant, heart transplant, or death. Student’s t-test was used to compare continuous variables and chi-square test for categorical variables. Cox Proportional Hazards model was used to identify univariate and multivariable models predicting GIB.
Results: Among the total 257 patients included, 65 (25.3%) were identified as having a GIB. Baseline differences and their independent univariate hazard ratio (HR) are noted in Table 1. Using stepwise selection and developing a multivariable model, prior GI abnormalities (HR=2.12, p<0.01), prior percutaneous coronary intervention (PCI: HR=2.65, P<0.01) and chronic obstructive pulmonary disease (COPD: HR=1.73, P<0.01) remained statistically significant predictors of GIB (Table 2).
Conclusions: We describe novel risk factors (history of GI abnormalities, prior PCI, COPD) as predictors for developing GIB post CF-LVAD implantation. We advocate a closer examination of these risk factors when evaluating patients for CF-LVAD therapy.