Effect of Gender on the Risk of Neurologic Events and Subsequent Outcomes in Patients With Left Ventricular Assist Devices.

Authors

• Saadia Sherazi
• Valentina Kutyifa
• Scott McNitt
• Anna Papernov
• William Hallinan
• Leway Chen
• Eugene Storozynsky
• Brent A Johnson
• Robert L Strawderman
• H Todd Massey
• Wojciech Zareba
• Jeffrey D Alexis

Publication/Presentation Date

1-15-2017

Abstract

Previous studies have shown that women with continuous-flow left ventricular assist devices (LVADs) are at greater risk of neurologic events. However, the relation between neurologic events and subsequent outcomes by gender is not well understood. We aimed to identify gender differences in the risk of neurologic events in patients with LVAD and the impact of time-dependent neurologic event on all-cause mortality by gender. Our study included 34 women and 157 men who received a HeartMate II LVAD at the University of Rochester Medical Center, Rochester, New York, from May 5, 2008, to June 5, 2014. Neurologic event was defined as a transient ischemic attack or cerebrovascular accident (hemorrhagic or ischemic). During a median follow-up of 25 months, 16 women (47%) and 20 men (13%) had neurologic events. Among patients with neurologic events, 7 women (44%) and 9 men (45%) died. Women had a 4.67-fold greater risk of neurologic events (hazard ratio [HR] 4.67, 95% confidence interval [CI] 2.26 to 9.66, p < 0.001) compared with men. Women with neurologic events had an increased risk of all-cause mortality compared to women without neurologic event (HR 4.84, 95% CI 1.33 to 17.55, p = 0.017). Similarly, men with neurologic events had an increased risk of all-cause mortality compared to men without neurologic event (HR 4.20, 95% CI 1.93 to 9.17, p < 0.001, interaction p = 0.854). In conclusion, among patients with LVAD, women are at greater risk of neurologic event compared to men. Both women and men after LVAD have similar high risk of all-cause mortality after neurologic events.

Volume

119

Issue

2

First Page

297

Last Page

301

ISSN

1879-1913

Published In/Presented At

Sherazi, S., Kutyifa, V., McNitt, S., Papernov, A., Hallinan, W., Chen, L., Storozynsky, E., Johnson, B. A., Strawderman, R. L., Massey, H. T., Zareba, W., & Alexis, J. D. (2017). Effect of Gender on the Risk of Neurologic Events and Subsequent Outcomes in Patients With Left Ventricular Assist Devices. The American journal of cardiology, 119(2), 297–301. https://doi.org/10.1016/j.amjcard.2016.09.032

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

27839770

Department(s)

Administration and Leadership

Document Type

Article