Contemporary Trends in Disparities of LVAD Use in HFrEF with Jose Lopez, MD


Research presented at the Heart Failure Society of America (HFSA) 2023 Annual Scientific Meeting is providing new information about trends in racial disparities in left ventricular assist devices (LVADs) for the population with heart failure.

Presented by Jose Lopez, MD, cardiology fellow at the University of Miami JFK Medical Center, the study results showed that Black race was associated with increased LVAD use relative to their non-Hispanic White counterparts, but Lopez cautioned that this was not positive. The findings suggest that white patients were more likely to receive transplants than their black or Hispanic counterparts.1

“We are putting LVADs in patients, perhaps with the intention of creating a bridge to transplant later, but we are leaving these patients with an LVAD,” Lopez explained in an interview with HCPLive Cardiology at HFSA 2023. Patients with low socioeconomic status and patients of black or Hispanic race and ethnicity.

Citing previous research on racial disparities in heart failure management,2 Lopez and a team of colleagues initiated the current study with the intention of exploring contemporary trends in LVAD use. To do this, the investigators conducted the current research effort using data recorded from the 2016-2019 National Inpatient Sample for adult patients with heart failure with reduced ejection fraction (HFrEF), a multicenter, national, retrospective cohort study. As designed.1

Using data from 7,674,108 HFrEF-related hospital admissions during the study period, the investigators planned to stratify the sample into black, Hispanic, and white groups to determine the rate of LVAD use per 100,000 admissions, which was evaluated using multivariable regression. The analysis was done using. Of the 7.6 million HFrEF-related hospitalizations, 0.2% (n=14,665) underwent LVAD placement.1

Baseline comparisons of stratified groups revealed that black patients were more likely to have lower socioeconomic status and to be enrolled in Medicaid than their Hispanic and white counterparts. When analyzed, study results showed that black patients had higher rates of LVAD use compared to white and Hispanic patients (P <.001). The investigators reported that, although this indicates that there may no longer be a disparity in access to LVADs for black patients, the results suggest a displacement toward LVAD therapy while systematically preferring heart transplantation for white patients. Are.1

As part of our on-site coverage of HFSA 2023, the editorial team HCPLive Cardiology Sat down with Lopez to learn more about this study, the results, and how he interprets the findings. That interview is the subject of the following video.

Lopez has no disclosures to report.

Reference:

  1. Lopez J, Duarte G, Mark J, et al., Racial and ethnic disparities in contemporary use of left ventricular assist devices in the United States. Paper presented at: Heart Failure Society of America 2023 Annual Scientific Meeting; October 6 – 9; Cleveland, OH. Accessed October 7, 2023.
  2. Morris A, Shah KS, Enciso JS, et al. The impact of health care disparities on patients with heart failure. j card failed, 2022;28(7):1169-1184. doi:10.1016/j.cardfail.2022.04.008

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