Status 2 patients had poor prognosis without mechanical circulatory support - Indications for device implantation -

Teruhiko Imamura, Koichiro Kinugawa, Masaru Hatano, Takeo Fujino, Toshiro Inaba, Hisataka Maki, Osamu Kinoshita, Eisuke Amiya, Kan Nawata, Atsushi Yao, Shunei Kyo, Minoru Ono, Issei Komuro

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15 Citations (Scopus)

Abstract

Background: Indication for mechanical circulatory support (MCS) has been a matter of debate in less sick status 2 patients. Methods and Results: Data were obtained from 183 consecutive patients assigned to stage D heart failure (HF) who were evaluated by the institutional review board of the University of Tokyo Hospital and then listed for heart transplantation as status 1 or 2 of the Japan Organ Transplant Network. Patients with status 2 (n=38) had a prognosis as poor as those dependent on inotropes (n=54) or MCS (n=91; P=0.615, log-rank test), and only 4 of them had eventual ventricular assist device (VAD) implantation (10.5%). Patients who eventually received VAD (n=92) had better 4-year survival than those without MCS among status 1 and 2 (P=0.030, log-rank test). On Cox regression analysis plasma B-type natriuretic peptide (BNP) >740 pg/ml was the only significant predictor for 4-year survival among the status 2 group (P=0.014; hazard ratio, 8.267). Ten patients with status 2 died: 6 due to acute hemodynamic compromise and 4 due to ventricular fibrillation. Conclusions: Prognosis in status 2 patients was as poor as that of those dependent on inotrope infusion or VAD, mostly because of out-of-hospital sudden death without MCS. Status 2 patients with considerably high plasma BNP may be good candidates for continuous flow VAD therapy.

Original languageEnglish
Pages (from-to)1396-1404
Number of pages9
JournalCirculation Journal
Volume78
Issue number6
DOIs
Publication statusPublished - 2014
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Imamura, T., Kinugawa, K., Hatano, M., Fujino, T., Inaba, T., Maki, H., Kinoshita, O., Amiya, E., Nawata, K., Yao, A., Kyo, S., Ono, M., & Komuro, I. (2014). Status 2 patients had poor prognosis without mechanical circulatory support - Indications for device implantation -. Circulation Journal, 78(6), 1396-1404. https://doi.org/10.1253/circj.CJ-14-0077