Left Ventricular Assist Device in Patients with History of Alcohol Abuse or Substance Abuse: An INTERMACS Analysis

Purpose In order to understand the impact of history of alcohol and illicit substance abuse on outcomes after left ventricular assist device (LVAD) implantation, we analyzed the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) registry. Methods All patients entered into the INTERMACS registry who received a continuous-flow LVAD (CF-LVAD) from June 2006 to December 2017 were included. Patients who had a temporary LVAD, pulsatile-flow LVAD, right ventricular assist device (RVAD), total artificial hearts, or biventricular assist devices were excluded. The Median follow-up duration was 13.3 months (IQR 5.3-28.3). Multivariable Cox proportional hazards model was performed to compare survival in patients with history of alcohol or substance abuse with the rest of the population (control). Results There were a total of 15069 patients in the final study group with 1184 patients with history of alcohol abuse and 1139 patients with history of substance abuse. The mean age in alcohol abuse and substance abuse group were 53.3 ± 12.4 (years), and 47.6 ± 12.5 (years), while the mean age in control group was 57.8 ± 12.8 (years). The overall mortality rate during the follow-up in alcohol abuse and substance abuse group were 24.8%, and 21.0%, respectively, compared with 28.7% in control. There was no significant difference in adjusted mortality between the history of alcohol abuse group and control (HR, 0.97, 95% CI, 0.86-1.10, p = 0.62). Similarly, there was no difference between the history of substance abuse group and control (HR, 0.95, 95% CI, 0.83-1.10, p = 0.51) (Figure). Conclusion Our findings suggest that patients with history of alcohol abuse or substance abuse have similar mortality rates as control.