Racial Disparities among Patients Undergoing Left Ventricular Assist Device: A Single Center Experience

Purpose The impact of race on outcomes of left ventricular assist device (LVAD) recipients remains a topic of debate as prior studies have demonstrated inconsistent results. We thought to investigate clinical outcomes of Hispanics LVAD recipients compared to Caucasians and African Americans at our institution. Methods We retrospectively identified LVAD recipients between 2009 and 2018. Patients were stratified according to race. Demographics and clinical acuity data were collected. The primary endpoint was survival. Secondary outcomes included the incidence of thrombosis, neurological events (NE), infection (INX), and right heart failure (RHF). The Kaplan-Meier method was used to compare survival between the two groups. The Cox proportional hazards regression model was used to conduct multivariable analysis. Results A total of 147 patients were included in the analysis (62 Hispanics, 39 Caucasians, 46 African Americans). The prevalence of hypertension was highest among Hispanics (69%) compared to Caucasians (41%) and African Americans (54%), p = 0.018. Similarly, more Hispanics suffered from diabetes (55%, 31%, 30%, p = 0.015). Unadjusted 1-year survival was not significantly different among the groups (p = 0.222 by log-rank test). Among the clinical acuity factors analyzed, total bilirubin was a predictor of mortality (HR 1.24 95% CI 1.05-1.47, p = 0.010). The incidence of thrombosis, NE, INX, and RHF were not significantly different among the three groups. Conclusion Race does not appear to impact clinical outcomes of advanced heart failure patients undergoing LVAD implantation. Total bilirubin at the time of LVAD implantation is a strong predictor of mortality.