Guilherme H Oliveira1, Matthias Dupont2, David Naftel3, Susan L Myers3, Ya Yuan3, W H Wilson Tang4, Gonzalo Gonzalez-Stawinski5, James B Young4, David O Taylor4, Randall C Starling4. 1. Advanced Heart Failure and Transplantation Center, Division of Cardiovascular Medicine, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio. Electronic address: guilherme.oliveira@UHhospitals.org. 2. Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium. 3. Cardiovascular Surgery Research, University of Alabama at Birmingham, Birmingham, Alabama. 4. Advanced Heart Failure and Transplantation Center, Division of Cardiovascular Medicine, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio. 5. Department of Cardiothoracic Surgery, Baylor Medical Center, Dallas, Texas.
Abstract
OBJECTIVES: The aim of this study was to investigate the use of durable mechanical circulatory support (MCS) in patients with chemotherapy-induced cardiomyopathy (CCMP) and determine their outcomes and survival in comparison to that of other patients with end-stage heart failure treated similarly. BACKGROUND: Patients with end-stage heart failure as a result of CCMP from anthracyclines are often precluded from heart transplantation because of a history of cancer. In such patients, durable MCS may offer an important chance for life prolongation. Yet, there are no data to support the use of MCS in this increasingly prevalent group of patients. METHODS: We searched 3,812 MCS patients from June 2006 through March 2011 in the INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) database for the diagnosis of CCMP. We compared characteristics, outcomes, and survival between CCMP patients and patients with nonischemic cardiomyopathy and ischemic cardiomyopathy. RESULTS: Compared with patients with nonischemic cardiomyopathy and ischemic cardiomyopathy, patients with CCMP were overwhelmingly female (72% vs. 24% vs. 13%, p = 0.001), had MCS more often implanted as destination therapy (33% vs. 14% vs. 22%, p = 0.03), required more right ventricular assist device support (19% vs. 11% vs. 6%, p = 0.006), and had a higher risk of bleeding (p = 0001). Survival of CCMP patients was similar to that of other groups. CONCLUSIONS: CCMP patients treated with MCS have survival similar to other MCS patients despite more frequent need for right ventricular assist device support and increased bleeding risk.
OBJECTIVES: The aim of this study was to investigate the use of durable mechanical circulatory support (MCS) in patients with chemotherapy-induced cardiomyopathy (CCMP) and determine their outcomes and survival in comparison to that of other patients with end-stage heart failure treated similarly. BACKGROUND:Patients with end-stage heart failure as a result of CCMP from anthracyclines are often precluded from heart transplantation because of a history of cancer. In such patients, durable MCS may offer an important chance for life prolongation. Yet, there are no data to support the use of MCS in this increasingly prevalent group of patients. METHODS: We searched 3,812 MCSpatients from June 2006 through March 2011 in the INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) database for the diagnosis of CCMP. We compared characteristics, outcomes, and survival between CCMPpatients and patients with nonischemic cardiomyopathy and ischemic cardiomyopathy. RESULTS: Compared with patients with nonischemic cardiomyopathy and ischemic cardiomyopathy, patients with CCMP were overwhelmingly female (72% vs. 24% vs. 13%, p = 0.001), had MCS more often implanted as destination therapy (33% vs. 14% vs. 22%, p = 0.03), required more right ventricular assist device support (19% vs. 11% vs. 6%, p = 0.006), and had a higher risk of bleeding (p = 0001). Survival of CCMPpatients was similar to that of other groups. CONCLUSIONS:CCMPpatients treated with MCS have survival similar to other MCSpatients despite more frequent need for right ventricular assist device support and increased bleeding risk.
Authors: Wilson Nadruz; Erin West; Morten Sengeløv; Gabriela L Grove; Mário Santos; John D Groarke; Daniel E Forman; Brian Claggett; Hicham Skali; Anju Nohria; Amil M Shah Journal: Heart Date: 2018-05-15 Impact factor: 5.994