LV-Advantage of Guideline-Directed Medical Therapy (GDMT) in Left Ventricular Assist Device (LVAD) Patients

Document Type

Conference Proceeding

Publication Date

1-8-2025

Publication Title

Am J Health Syst Pharm

Abstract

Purpose: Despite adherence to optimal guideline-directed medical therapies (GDMT), many patients progress to end-stage heart failure, which poses a significant burden on both patients and healthcare systems. One treatment option for these individuals is the implantation of a left ventricular assist device (LVAD), which has increasingly been shown to reduce heart failure-related morbidity and mortality. However, there is limited guidance on managing GDMT and its potential benefits in patients with LVADs. This study aims to evaluate various aspects of GDMT, including medication classes, doses, adherence levels, and intolerances which will help provide a comprehensive understanding of medication management in this population. Methods: This IRB-approved, retrospective, observational study will assess all adult patients presenting to an academic medical center for an LVAD implantation between January 1st to December 31st, 2023. This study will evaluate patients for up to one year after LVAD implantation. Patients who are 18 years of age or older and have the presence of a durable LVAD will be included. Vulnerable patient populations, patients expired before discharge from index surgical admission, and patients that received alternate invasive cardiothoracic procedures will be excluded. The primary outcome is the percentage of LVAD patients receiving appropriate GDMT following their procedure within one year. Key secondary outcomes will include ejection fraction, number of heart failure related hospital readmissions, number and/or reason of patients not receiving all 4 classes of GDMT, and proportion of patients on each GDMT medication class at each follow-up period. Data collection will include baseline patient demographics, patient comorbidities, left ventricular ejection fraction percentage, serum creatinine, medications classified as GDMT and related to heart failure, medication tolerability, and hospital readmissions related to heart failure within 12 months following LVAD implantation. Data will be analyzed using descriptive statistics. A convenience sample of around 50 patients will be included.

Volume

82

First Page

S1206

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