Decreased Utilization of Durable Left Ventricular Assist Device Therapy in Blacks Relative to Whites with Advanced Heart Failure

Purpose Heart failure affects 6 million people in the US, and is most prevalent in Blacks who suffer the highest mortality risk[1, 2]. Yet prior studies have suggested that black patients are less likely to receive advanced heart failure therapy[3-6]. We hypothesized that black patients would have decreased rates of durable LVAD implantation within our expansive heart failure program. Methods A retrospective single center cohort study was conducted using electronic medical record data at our high-volume academic medical center. Patients between 18 and 85 years admitted with a diagnosis of cardiogenic shock or congestive heart failure between 1/2013 and 12/2017 with an LVEF Results A total of 702 patients were included, of which 60.8% were white and 34.2% were Black; 72% of the patients in the study were men. Comorbidities were similar among the racial groups with the exception of coronary artery disease (CAD), which had an increased prevalence in whites (N=248; 58%). White patients were older (65 vs 59; p Conclusion Black patients in our study had a decreased rate of durable LVAD implantation compared with white patients after adjustments were made for age, gender and clinical covariates. While this finding was likely mediated by socioeconomic factors, larger prospective studies are needed to validate these findings.