Document Detail


Body mass index and outcomes after left ventricular assist device placement.
MedLine Citation:
PMID:  15620917     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although extremes of body mass index (BMI) are associated with decreased survival after cardiac transplantation, its association with outcomes after left ventricular assist device (LVAD) implantation is not known. This issue is especially important as LVADs are now approved as destination therapy for advanced heart failure patients who are not transplant candidates. In this study, we assess the association between BMI and outcomes after LVAD implantation. METHODS: A total of 222 patients who underwent LVAD placement (190 bridge-to-transplant [BTT] and 32 destination therapy) were divided into four groups based on BMI (kg/m2) quartiles (group 1, <22.9; group 2, 22.9 to 26.3; group 3, 26.4 to 29.4; and group 4, >29.4) and were compared for outcomes. RESULTS: Eighty-four patients died on LVAD support. Six- and 12-month survival on LVAD for the four groups was 35%, 60%, 65%, and 73%, and 26%, 34%, 50%, and 66% (both p < 0.01), respectively. Similar trends were seen for the composite endpoint of survival on LVAD and within 30 days posttransplant among BTT patients. Infectious, neurological, respiratory, or bleeding complications were not related to BMI. Patients with higher BMI tended to have a greater risk of reoperations (43%, 49%, 53%, and 61%, p = 0.06) and renal complications (16%, 33% 23%, 43%, p = 0.03). Age and history of thoracotomy were independently associated with mortality whereas higher BMI was not. Survival was worst for patients with lowest BMI. CONCLUSIONS: Higher BMI did not adversely affect survival after LVAD implantation and therefore relative obesity should not be considered a contraindication for LVAD placement. Further work is needed to understand and manage risks for low BMI patients.
Authors:
Javed Butler; Renee Howser; Peer M Portner; Richard N Pierson
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  79     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2004-12-28     Completed Date:  2005-08-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  66-73     Citation Subset:  AIM; IM    
Affiliation:
Cardiology Division, Center for Education and Research in Therapeutics, Vanderbilt University, Nashville VAMC, Nashville, Tennessee, USA. javed.butler@vanderbilt.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Body Mass Index*
Cause of Death
Clinical Trials as Topic / statistics & numerical data
Female
Heart Diseases / mortality,  surgery,  therapy
Heart Transplantation / statistics & numerical data
Heart-Assist Devices*
Humans
Male
Middle Aged
Multicenter Studies as Topic / statistics & numerical data
Postoperative Complications / mortality*
Registries
Retrospective Studies
Survival Analysis
Thinness
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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