Abstract 4143583: Impact of Heart Failure Readmission in HeartMate 3 LVAD Recipients

Background: Despite the survival benefit of durable left ventricular assist device (LVAD) therapy in patients with advanced heart failure, hospital readmissions due to heart failure (HF) remain a significant morbidity and determinant of quality of life. Objective: This study aimed to characterize patients with and without a HF readmission and determine its clinical impact following HeartMate 3 (HM3) LVAD implantation. Methods/Approach: A single-center retrospective analysis was performed of patients who underwent HM3 LVAD implantation from January 1, 2015 to December 31, 2021. Patients with and without a HF readmission were compared based on 53 variables. Cox proportional hazard model was performed to investigate the association between HF readmission and survival. Results: A total of 273 patients underwent HM3 implantation. The average implant age was 58 years, 75% were men, and 78% were Black patients. Of the 273 patients, 78 (29%) had a HF readmission and 58 (74%) occurred within the first year following implant. Predictors of a HF readmission include pre-implant diabetes mellitus (HR 1.96; 95% CI, 1.2-3.2; p=0.007), pre-implant body mass index (HR 1.05; 95% CI, 1.02-1.09; p<0.001) and post implant BUN (HR 1.02; 95% CI, 1-1.04; p=0.018). There was no significant difference in survival in patients with and without a HF readmission (multivariate-adjusted HR 1.44; 95% CI, 0.87-2.37; p=0.153; Figure) at long-term follow up (6 years). Conclusion: Readmissions for HF remain an opportunity for improvement in the care of HM3 LVAD patients. However, a HF readmission was not associated with an increased risk of death. Addressing comorbid conditions and identifying strategies to optimize LVAD and HF management in this high-risk cohort warrant further exploration to improve clinical outcomes.