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• W1997361470 abstract "PurposePre-HT diagnosis of ICM has become less prevalent over time in large part due to advances in revascularization leading to more advanced presentations at time of HT. We sought to study survival by era in this population.Methods and Materials39759 HT recipients (exclusions included age<18 & multiorgan) were identified from UNOS (1987-2011) & stratified by etiology & era. Survival was censored at 12y. Multivariate Cox proportional hazard regression analysis was adjusted for age, sex, DM, race, ischemic time, dialysis, life support, wait time & HLA mismatch.Results19087 (48%) pts were ischemic (Era 1-1987-94: 6107 (52%); Era 2-1995-99: 4703 (52%); Era 3-2000-2004: 3696 (47%); Era 4-2005-11: 4581 (41%). Age and diabetes increased by era (p < 0.001). Prior cardiac surgery increased by era (Era 1-4: 0.1%, 0.5%, 10.0%, 55%; p < 0.001). VAD use increased by era (Era 1-4: 3%, 13%, 24%, 30%; p < 0.001). Creatinine progressively decreased by era (p<0.001). Pts listed Status 1 increased by era (Era 1-4: 53%, 69%, 72%, 87%; p <0.001). Survival is shown in Figure 1 by ICM (A); era & ICM (B-D). Unadjusted HR (CI) for all-cause mortality (as compared to era 1) was era 2 [0.84 (0.80-0.89)]; era 3 [0.75 (0.71-0.79)] & era 4 [0.67 (0.62-0.72)]. After adjustment, all-cause mortality (as compared to era 1) was era 2 [0.71 (0.67-0.76)]; era 3 [0.61 (0.56-0.65)] & era 4 [0.53 (0.48-0.58)].ConclusionsPost HT survival improves by era in ICM pts despite increasing pt complexity (i.e. increased Status 1 pts, prior cardiac surgery, older age, diabetes, and increased VAD use). Pre-HT diagnosis of ICM has become less prevalent over time in large part due to advances in revascularization leading to more advanced presentations at time of HT. We sought to study survival by era in this population. 39759 HT recipients (exclusions included age<18 & multiorgan) were identified from UNOS (1987-2011) & stratified by etiology & era. Survival was censored at 12y. Multivariate Cox proportional hazard regression analysis was adjusted for age, sex, DM, race, ischemic time, dialysis, life support, wait time & HLA mismatch. 19087 (48%) pts were ischemic (Era 1-1987-94: 6107 (52%); Era 2-1995-99: 4703 (52%); Era 3-2000-2004: 3696 (47%); Era 4-2005-11: 4581 (41%). Age and diabetes increased by era (p < 0.001). Prior cardiac surgery increased by era (Era 1-4: 0.1%, 0.5%, 10.0%, 55%; p < 0.001). VAD use increased by era (Era 1-4: 3%, 13%, 24%, 30%; p < 0.001). Creatinine progressively decreased by era (p<0.001). Pts listed Status 1 increased by era (Era 1-4: 53%, 69%, 72%, 87%; p <0.001). Survival is shown in Figure 1 by ICM (A); era & ICM (B-D). Unadjusted HR (CI) for all-cause mortality (as compared to era 1) was era 2 [0.84 (0.80-0.89)]; era 3 [0.75 (0.71-0.79)] & era 4 [0.67 (0.62-0.72)]. After adjustment, all-cause mortality (as compared to era 1) was era 2 [0.71 (0.67-0.76)]; era 3 [0.61 (0.56-0.65)] & era 4 [0.53 (0.48-0.58)]. Post HT survival improves by era in ICM pts despite increasing pt complexity (i.e. increased Status 1 pts, prior cardiac surgery, older age, diabetes, and increased VAD use)." @default.
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• W1997361470 date "2013-04-01" @default.
• W1997361470 modified "2023-09-25" @default.
• W1997361470 title "Outcomes in Patients with Ischemic Cardiomyopathy (ICM) Post-Heart Transplant (HT) by Era" @default.
• W1997361470 doi "https://doi.org/10.1016/j.healun.2013.01.233" @default.
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