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Sex differences in eligibility for advanced heart failure therapies
Author(s) -
Steinberg Rebecca S.,
Nayak Aditi,
O'Connell Celena,
Burford Sharon,
Pekarek Ann,
Chesnut Neile,
Cole Robert T.,
Gupta Divya,
Laskar S. Raja,
Bhatt Kunal,
Burke Michael,
Attia Tamer,
Smith Andrew,
Vega J. David,
Morris Alanna A.
Publication year - 2020
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13839
Subject(s) - medicine , confidence interval , odds ratio , heart failure , logistic regression , retrospective cohort study , cohort , ventricular assist device , heart transplantation , cardiology
Objectives We investigated sex‐based differences in eligibility for and outcomes after receipt of advanced heart failure (HF) therapies. Background Although women are more likely to die from HF than men, registry data suggest that women are less likely to receive heart transplant (HT) or left ventricular assist device (LVAD) for largely unknown reasons. Methods We performed a single‐center retrospective cohort study of patients evaluated for advanced HF therapies from 2012 to 2016. Logistic regression was used to determine the association of sex with eligibility for HT/LVAD. Competing risks and Kaplan‐Meier analysis were used to examine survival. Results Of 569 patients (31% women) evaluated, 223 (39.2%) were listed for HT and 81 (14.2%) received destination (DT) LVAD. Women were less likely to be listed for HT (adjusted odds ratio [OR] 0.36, 95% confidence interval [CI] 0.21‐0.61; P < .0001), based on allosensitization ( P < .0001) and obesity ( P = .02). Women were more likely to receive DT LVAD (adjusted OR 2.29, 95% CI 1.23‐4.29; P = .01). Survival was similar between men and women regardless of whether they received HT and DT LVAD or were ineligible for therapy. Conclusion Women are less likely to be HT candidates, but more likely to receive DT LVAD.