Characteristics and Outcomes of African American LVAD Recipients: A Single Center Experience

African Americans (AA) have a higher prevalence of heart failure than other racial/ethnic groups. Furthermore, AA with heart failure have a higher mortality and those who undergo heart transplantation have a lower survival. The outcomes and survival of AA patients who undergo LVAD implantation is not well defined. We performed a single center retrospective review of patients implanted with a LVAD between January, 2010 and September, 2015. We compared clinical characteristics and survival of AA vs. all other patients. A total of 278 patients underwent LVAD implantation, of whom 170 (61%) were AA. Compared to non-AA patients, the AA group had a longer mean time on LVAD support (560±473 vs. 445±465 days, p=0.05). AA were younger (54±12.5 vs. 59±13.6 years, p<0.001), included more women (35% vs. 19%, p=0.003), had a higher BMI (29.4±6.5 vs. 27.0±5.5, p=0.001), had more non-ischemic cardiomyopathy (76% vs 41%, p<0.001), and had less previous sternotomies (13% vs. 29%, p=0.001). There were no significant differences between the 2 groups in the pre-operative INTERMACS profiles, kidney/liver function, implant strategy (BTT or DT), or the type of LVAD (axial vs. centrifugal pump). During the index hospitalization for LVAD implantation, there were no significant differences between the AA and non-AA groups in terms of days on vasopressor or inotropic therapy and length of stay (30.4±20.6 vs. 26.1 ±21.1, p=0.09),. After discharge, the rate of 30-day re-hospitalization was similar between the 2 groups (27% vs 24%, p=0.58). AA had a lower unadjusted mortality at 90 days (12.4% vs. 23.8%) and at 1 year (Figure). This is the largest reported cohort of AA with LVADs from a single institution. AA race did not adversely affect length of stay, early re-hospitalization or survival after LVAD implantation. Whether race impacts thrombotic, bleeding, or infectious complications deserves further study.