TY - JOUR
T1 - Novel Scoring System to Risk Stratify Patients Receiving Durable Left Ventricular Assist Device From J-MACS Registry Data
AU - J-MACS investigators
AU - Imamura, Teruhiko
AU - Kinugawa, Koichiro
AU - Nishimura, Takashi
AU - Toda, Koichi
AU - Saiki, Yoshikatsu
AU - Niinami, Hiroshi
AU - Nunoda, Shinichi
AU - Matsumiya, Goro
AU - Nishimura, Motonobu
AU - Arai, Hirokuni
AU - Yanase, Masanobu
AU - Fukushima, Norihide
AU - Nakatani, Takeshi
AU - Shiose, Akira
AU - Shibasaki, Ikuko
AU - Sakata, Yasushi
AU - Ono, Minoru
N1 - Publisher Copyright:
© 2023 Japanese Circulation Society. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Background: Recently, destination therapy (DT) was approved in Japan, and patients ineligible for heart transplantation may now receive durable left ventricular assist devices (LVADs). Several conventional risk scores are available, but a risk score that is best to select optimal candidates for DT in the Japanese population remains unestablished. Methods and Results: A total of 1,287 patients who underwent durable LVAD implantation and were listed for the Japanese registry for Mechanically Assisted Circulatory Support (J-MACS) were eligible for inclusion. Finally, 494 patients were assigned to the derivation cohort and 487 patients were assigned to the validation cohort. According to the time-to-event analyses, J-MACS risk scores were newly constructed to predict 3-year mortality rate, consisting of age, history of cardiac surgery, serum creatinine level, and central venous pressure to pulmonary artery wedge pressure ratio >0.71. The J-MACS risk score had the highest predictability of 3-year death compared with other conventional scores in the validation cohort, including HeartMate II risk score and HeartMate 3 risk score. Conclusions: We constructed the J-MACS risk score to estimate 3-year mortality rate after durable LVAD implantation using large-scale multicenter Japanese data. The clinical utility of this scoring to guide the indication of DT should be validated in the next study.
AB - Background: Recently, destination therapy (DT) was approved in Japan, and patients ineligible for heart transplantation may now receive durable left ventricular assist devices (LVADs). Several conventional risk scores are available, but a risk score that is best to select optimal candidates for DT in the Japanese population remains unestablished. Methods and Results: A total of 1,287 patients who underwent durable LVAD implantation and were listed for the Japanese registry for Mechanically Assisted Circulatory Support (J-MACS) were eligible for inclusion. Finally, 494 patients were assigned to the derivation cohort and 487 patients were assigned to the validation cohort. According to the time-to-event analyses, J-MACS risk scores were newly constructed to predict 3-year mortality rate, consisting of age, history of cardiac surgery, serum creatinine level, and central venous pressure to pulmonary artery wedge pressure ratio >0.71. The J-MACS risk score had the highest predictability of 3-year death compared with other conventional scores in the validation cohort, including HeartMate II risk score and HeartMate 3 risk score. Conclusions: We constructed the J-MACS risk score to estimate 3-year mortality rate after durable LVAD implantation using large-scale multicenter Japanese data. The clinical utility of this scoring to guide the indication of DT should be validated in the next study.
KW - Heart failure
KW - Hemodynamics
KW - Mechanical circulatory support
KW - Mortality
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U2 - 10.1253/circj.CJ-23-0264
DO - 10.1253/circj.CJ-23-0264
M3 - Article
C2 - 37258218
AN - SCOPUS:85166363611
SN - 1346-9843
VL - 87
SP - 1103
EP - 1111
JO - Circulation Journal
JF - Circulation Journal
IS - 8
ER -