Identifying ambulatory advanced heart failure patients at high risk for death, LVAD or transplant at 1-year: How did the revival eligibility criteria perform?
Aaronson KD, Stevenson LW, Pagani FD, Spino C, Kormos RL, Khalatbari S, Baldwin JT, Jeffries N, Taddei-Peters WC, Ambardekar AV, Shah P, McNamara D, Lanfear D, Gorcsan J, Stehlik J, Mancini DM, Stewart GC, Mann DL. Identifying ambulatory advanced heart failure patients at high risk for death, LVAD or transplant at 1-year: How did the revival eligibility criteria perform? J Heart Lung Transplant. 2018;37(4):S195-S196.
J Heart Lung Transplant
Purpose: Identifying ambulatory advanced heart failurepatients who are at high risk for receiving an LVAD, a transplant or death is important in appropriately guiding clinical care, and in selecting patients for clinical trials. We evaluated the REVIVAL Registry inclusion criteria to determine their ability to identify patients who experienced any of these events within 1 year of enrollment. Methods: REVIVAL is a 400 patient, 21 center registry of patients with ambulatory advanced heart failure. Exclusion criteriaapproximated thoseof VAD clinical trials. Patients were eligible for inclusion if they met any of eight high riskcharacteristics (first 8 rows of Table) or if they had ≥ 2 HF hospitalizations in the prior year. As clinically indicated testing was utilized for inclusion, data were not available for all subjects for each criterion. Sensitivity, specificity, positive and negative predictive values were determined foreach inclusion criterion and for selected combinations Results: At 12 months, 359 evaluable subjects experienced 46 LVADs, 20 transplants and 29 deaths for a total of 95 events (26%). Competing outcome curves are shown in theFigure and test performance in the Table Conclusion: Theuse of multiple inclusion criteria applied to only clinically available information allowed identification of a high risksample of ambulatory advanced heart failure patients with a 26% event rate at 1 year. These findings can inform theselection of patients for future clinical trials in ambulatoryadvanced heart failure (Figure presented).