Improved survival of left ventricular assist device carriers in Europe according to implantation eras: results from the PCHF-VAD registry

Nina Jakus, Jasper J. Brugts, PCHF-VAD registry, Brian Claggett, Philippe Timmermans, Anne Catherine Pouleur, Pawel Rubiś, Emeline M. Van Craenenbroeck, Edvinas Gaizauskas, Eduardo Barge-Caballero, Stefania Paolillo, Sebastian Grundmann, Domenico D'Amario, Oscar Braun, Aggeliki Gkouziouta, Bart Meyns, Walter Droogne, Karol Wierzbicki, Katarzyna Holcman, Ivo PlanincBosko Skoric, Andreas J. Flammer, Hrvoje Gasparovic, Bojan Biocina, Lars H. Lund, Davor Milicic, Frank Ruschitzka, Maja Cikes*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)

Abstract

Aims: Temporal changes in patient selection and major technological developments have occurred in the field of left ventricular assist devices (LVADs), yet analyses depicting this trend are lacking for Europe. We describe the advances of European LVAD programmes from the PCHF-VAD registry across device implantation eras. Methods and results: Of 583 patients from 13 European centres in the registry, 556 patients (mean age 53 ± 12 years, 82% male) were eligible for this analysis. Patients were divided into eras (E) by date of LVAD implantation: E1 from December 2006 to December 2012 (6 years), E2 from January 2013 to January 2020 (7 years). Patients implanted more recently were older with more comorbidities, but less acutely ill. Receiving an LVAD in E2 was associated with improved 1-year survival in adjusted analysis (hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.35–0.98; p = 0.043). LVAD implantation in E2 was associated with a significantly lower chance of heart transplantation (adjusted HR 0.40, 95% CI 0.23–0.67; p = 0.001), and lower risk of LVAD-related infections (adjusted HR 0.64, 95% CI 0.43–0.95; p = 0.027), both in unadjusted and adjusted analyses. The adjusted risk of haemocompatibility-related events decreased (HR 0.60, 95% CI 0.39–0.91; p = 0.016), while heart failure-related events increased in E2 (HR 1.67, 95% CI 1.02–2.75; p = 0.043). Conclusion: In an analysis depicting the evolving landscape of continuous-flow LVAD carriers in Europe over 13 years, a trend towards better survival was seen in recent years, despite older recipients with more comorbidities, potentially attributable to increasing expertise of LVAD centres, improved patient selection and pump technology. However, a smaller chance of undergoing heart transplantation was noted in the second era, underscoring the relevance of improved outcomes on LVAD support.

Original languageEnglish
Pages (from-to)1305-1315
Number of pages11
JournalEuropean Journal of Heart Failure
Volume24
Issue number7
Early online date4 May 2022
DOIs
Publication statusPublished - Jul 2022

Bibliographical note

Funding Information:
N.J. reports non‐financial support from Servier, personal fees from AstraZeneca, Krka, Sanofi Genzyme, personal fees and non‐financial support from Teva Pharmaceutical Industries,Pfizer, non‐financial support from Abbott, outside the submitted work. J.J.B reports grants and personal fees from Abbott, outside the submitted work. B.C. reports personal fees from Amgen, Boehringer Ingelheim, Cardurion, Corvia, Myokardia, Novartis, outside the submitted work. E.B.C. reports grants from Abbott and Medtronic, during the conduct of the study. I.P. reports personal fees from Boehringer Ingelheim, Teva Pharmaceutical Industries, Servier, Sandoz, Corvia, personal fees and non‐financial support from Novartis, Pfizer, Krka, Bayer, Abbott, non‐financial support from Sanofi Aventis, outside the submitted work. A.J.F. reports personal fees from Alnylam, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Fresenius, Imedos, Medtronic, Pfizer, Roche, Schwabe Pharma, Vifor, Mundipharma, Zoll, non‐financial support from Amgen, grants and personal fees from AstraZeneca, Novartis, outside the submitted work. L.H.L. reports personal fees from Merck, Bayer, Pharmacosmos, Abbott, Medscape, Myokardia, Sanofi, Lexicon, grants and personal fees from Vifor‐Fresenius, AstraZeneca, Relypsa, Boehringer Ingelheim, Novartis, grants from Boston Scientific, outside the submitted work. D.M. reports personal fees from Boehringer Ingelheim, Bayer, Pfizer, Novartis, AstraZeneca, Novo Nordisk, Teva, Servier, outside the submitted work. F.R. has not received personal payments by pharmaceutical companies or device manufacturers in the last 3 years (remuneration for the time spent in activities, such as participation in steering committee member of clinical trials, were made directly to the University of Zurich). The Department of Cardiology (University Hospital of Zurich/University of Zurich) reports research‐, educational‐ and/or travel grants from Abbott, Amgen, AstraZeneca, Bayer, B. Braun, Biosense Webster, Biosensors Europe AG, Biotronik, BMS, Boehringer Ingelheim, Boston Scientific, Bracco, Cardinal Health Switzerland, Daiichi, Diatools AG, Edwards Lifesciences, Guidant Europe NV (BS), Hamilton Health Sciences, Kaneka Corporation, Labormedizinisches Zentrum, Medtronic, MSD, Mundipharma Medical Company, Novartis, Novo Nordisk, Orion, Pfizer, Quintiles Switzerland Sarl, Sanofi, Sarstedt AG, Servier, SIS Medical, SSS International Clinical Research, Terumo Deutschland, V‐Wave, Vascular Medical, Vifor, Wissens Plus, Zoll. The research and educational grants do not impact on Prof. Ruschitzka's personal remuneration. M.C. reports personal fees from Novartis, Bayer, Boehringer Ingelheim, AstraZeneca, Sanofi, Orion Pharma, Medtronic, grants and non‐financial support from Abbott, personal fees and non‐financial support from GE Healthcare, Pfizer, Teva Pharmaceutical Industries, non‐financial support from Corvia, outside the submitted work. All other authors have nothing to disclose. Conflict of interest:

Funding Information:
We acknowledge Pero Hrabac, MD, for the IT support in the setup of the REDCap hosting at the University of Zagreb School of Medicine. Conflict of interest: N.J. reports non-financial support from Servier, personal fees from AstraZeneca, Krka, Sanofi Genzyme, personal fees and non-financial support from Teva Pharmaceutical Industries,Pfizer, non-financial support from Abbott, outside the submitted work. J.J.B reports grants and personal fees from Abbott, outside the submitted work. B.C. reports personal fees from Amgen, Boehringer Ingelheim, Cardurion, Corvia, Myokardia, Novartis, outside the submitted work. E.B.C. reports grants from Abbott and Medtronic, during the conduct of the study. I.P. reports personal fees from Boehringer Ingelheim, Teva Pharmaceutical Industries, Servier, Sandoz, Corvia, personal fees and non-financial support from Novartis, Pfizer, Krka, Bayer, Abbott, non-financial support from Sanofi Aventis, outside the submitted work. A.J.F. reports personal fees from Alnylam, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Fresenius, Imedos, Medtronic, Pfizer, Roche, Schwabe Pharma, Vifor, Mundipharma, Zoll, non-financial support from Amgen, grants and personal fees from AstraZeneca, Novartis, outside the submitted work. L.H.L. reports personal fees from Merck, Bayer, Pharmacosmos, Abbott, Medscape, Myokardia, Sanofi, Lexicon, grants and personal fees from Vifor-Fresenius, AstraZeneca, Relypsa, Boehringer Ingelheim, Novartis, grants from Boston Scientific, outside the submitted work. D.M. reports personal fees from Boehringer Ingelheim, Bayer, Pfizer, Novartis, AstraZeneca, Novo Nordisk, Teva, Servier, outside the submitted work. F.R. has not received personal payments by pharmaceutical companies or device manufacturers in the last 3 years (remuneration for the time spent in activities, such as participation in steering committee member of clinical trials, were made directly to the University of Zurich). The Department of Cardiology (University Hospital of Zurich/University of Zurich) reports research-, educational- and/or travel grants from Abbott, Amgen, AstraZeneca, Bayer, B. Braun, Biosense Webster, Biosensors Europe AG, Biotronik, BMS, Boehringer Ingelheim, Boston Scientific, Bracco, Cardinal Health Switzerland, Daiichi, Diatools AG, Edwards Lifesciences, Guidant Europe NV (BS), Hamilton Health Sciences, Kaneka Corporation, Labormedizinisches Zentrum, Medtronic, MSD, Mundipharma Medical Company, Novartis, Novo Nordisk, Orion, Pfizer, Quintiles Switzerland Sarl, Sanofi, Sarstedt AG, Servier, SIS Medical, SSS International Clinical Research, Terumo Deutschland, V-Wave, Vascular Medical, Vifor, Wissens Plus, Zoll. The research and educational grants do not impact on Prof. Ruschitzka's personal remuneration. M.C. reports personal fees from Novartis, Bayer, Boehringer Ingelheim, AstraZeneca, Sanofi, Orion Pharma, Medtronic, grants and non-financial support from Abbott, personal fees and non-financial support from GE Healthcare, Pfizer, Teva Pharmaceutical Industries, non-financial support from Corvia, outside the submitted work. All other authors have nothing to disclose.

Publisher Copyright:
© 2022 European Society of Cardiology.

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