Abstract 11047: Racial Balance in Heart Failure Treatment, Use of Implantable Left Ventricular Assist Devices, and Cardiac Transplantation

Introduction: The incidence of left ventricular assist device (LVAD) implantation in heart failure (HF) patients across various racial groups has not been examined in large databases. We present an analysis of racial groups and LVAD implantation using a large US database. Methods: We analyzed data from a commercial and a national Medicare database using OPTUM® Clinformatic® Data Mart and a Medicare National Sample that comprised 57,585,519 US patients. We identified 346,345 adults with HF from 2014 to 2016. Comorbidities were identified including diabetes, coronary artery disease, hypertension, and cardiomyopathy. Data were collected for LVAD implantation, stroke, cerebral injury, mechanical ventilation, heart transplantation, renal insufficiency, and death through 2019 or until they were no longer enrolled. Race, sex, and age were discerned from enrollment information. Results: The incidence of HF was similar across all 5 racial groups (Table). Age at the time of HF diagnosis and LVAD implantation was lower in Blacks than in other races. LVADs were implanted at a higher rate in Blacks than in other groups. Age at LVAD implantation was lower in black men than in men of other races. Whites had a lower incidence of stroke, intracranial bleed, and cerebral injury after LVAD implantation than did Blacks, Hispanics, and Native Americans. The rate of eventual transplantation was similar among all groups. Because of the large database population analyzed, differences between groups were highly significant, with p<0.0001. Conclusions: In the largest US database analysis to date, we found that US racial groups showed no significant differences in the incidence of HF, rate of LVAD implantation, survival after LVAD implantation, or progression to cardiac transplantation. However, Blacks were diagnosed with HF and underwent LVAD implantation at somewhat younger ages than other groups.