Left Ventricular Device an Option for Transplant-Ineligible
Novacor left ventricular assist device evaluated for long-term circulatory support
THURSDAY, Aug. 16 (HealthDay News) -- Heart failure patients who aren't eligible for transplantation are more likely to survive if given a left ventricular assist device rather than optimal medical therapy, researchers report in the Aug. 21 issue of the Journal of the American College of Cardiology.
Joseph G. Rogers, M.D., of Duke University in Durham, N.C., and colleagues conducted INTrEPID (Investigation of Nontransplant-Eligible Patients Who Are Inotrope Dependent), a non-randomized trial of 55 patients who could not be weaned from inotropic support. All patients were offered a left ventricular assist device. Eighteen of the patients did not receive the device due to patient preference or unavailability and these patients served as the control group.
The patients were matched for demographics and disease severity. At six months, the patients with an assist device had a 46 percent survival compared to 22 percent of controls. Survival at 12 months was 27 percent and 11 percent, respectively. Adverse event rates were higher in the patients who were managed medically. Five of the assist-device patients and one of the controls improved enough to qualify for a transplant.
"A relative risk reduction of 50 percent is statistically significant, but the absolute mortality of 75 percent at one year is not an acceptable outcome for a device intended for durable support," according to an accompanying editorial.
The study was partly funded by WorldHeart in Oakland, Calif.