Calculator Can Help Tailor Treatment During, After Heart Pump Placement

In HealthDay News
by Healthday

STOP-RVF calculator predicts right ventricular failure, with C-statistics of 0.75 and 0.73 in derivation and validation cohorts

By Elana Gotkine HealthDay Reporter

MONDAY, Feb. 5, 2024 (HealthDay News) — The right ventricular failure (RVF) risk score, STOP-RVF calculator, can predict RVF after durable left ventricular assist device (LVAD) placement, according to a study published online Jan. 31 in JAMA Cardiology.

Iosif Taleb, M.D., from the University of Utah Health and School of Medicine in Salt Lake City, and colleagues derived and validated a risk model to predict RVF after LVAD implantation. Patients with advanced heart failure enrolled at five institutions were included in the derivation cohort (798 patients); patients enrolled at a sixth institution were included as the external validation cohort (327 patients). Several techniques were used to derive a predictive model; the RVF risk calculator (STOP-RVF) was developed and validated externally.

The researchers found that RVF developed in 24.2 and 32.7 percent of patients in the derivation and validation cohorts, respectively. Preimplant variables associated with postoperative RVF included nonischemic cardiomyopathy, intra-aortic balloon pump, microaxial percutaneous left ventricular assist device/venoarterial extracorporeal membrane oxygenation, and LVAD configuration. Model performance was not improved with inclusion of intraoperative variables. The C-statistic for the calculator was 0.75 and 0.73 in the derivation and validation cohorts, respectively. Patients comprising the low-risk group (estimated <20 percent RVF risk) had higher cumulative survival than those in the high-risk group. The STOP-RVF risk score exhibited significantly better performance than commonly used risk scores.

“The calculator could impact the selection of patients with both acute and chronic advanced heart failure undergoing advanced therapies evaluation, as well as assist in their perioperative optimization to reduce RVF-related morbidity and mortality,” the authors write.

Several authors disclosed ties to the pharmaceutical and medical device industries.

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