ArticleJACC. Heart failure2017
INTERMACS Analysis of Stroke During Support With Continuous-Flow Left Ventricular Assist Devices: Risk Factors and Outcomes.
Article in JACC. Heart failure, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 2 of them syntheses that pooled it.
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Who cites it
65 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Clinical and cost-effectiveness of left ventricular assist devices as destination therapy for advanced heart failure: systematic review and economic evaluation.Health technology assessment (Winchester, England) · 2024Pooled it
- Blood stream infection is associated with cerebrovascular accident in patients with left ventricular assist device: a systematic review and meta-analysis.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2018Pooled it
- Embolic Transport in LVAD Outflow: An Experimental Study Using Patient-Specific and Idealized Aortic Models.Annals of biomedical engineering · 2026Article
- Preoperative Left Ventricular Thrombus and Midterm Outcomes Following Left Ventricular Assist Device Support.Journal of clinical medicine · 2026Article
- Expanding the scope of SGLT inhibitors in underrepresented cardiac populations: from pathophysiology to clinical evidence.Frontiers in cardiovascular medicine · 2026Review
- Chronic kidney disease following left ventricular assist device implantation: contemporary insights and future perspectives.Heart failure reviews · 2025Review
- Understanding embolus transport and source to destination mapping of thromboemboli in hemodynamics driven by left ventricular assist device.Scientific reports · 2025Article
- Preoperative brain volume loss is associated with postoperative delirium in advanced heart failure patients supported by left ventricular assist device.Scientific reports · 2025Article
- Modelling blood flow in the circle of Willis in continuous flow left ventricular assist devices: possible relevance to strokes.Indian journal of thoracic and cardiovascular surgery · 2025Article
- Fibrin clot permeability (Ks) in patients on left ventricular assist device.Scientific reports · 2024Article
- Sex Does Matter: Risk of Stroke in LVAD Recipients.JACC. Advances · 2024Article
- Sex-Based Differences in Patients With Left Ventricular-Assisted Devices and Strokes.JACC. Advances · 2024Article
- Early stroke after left ventricular assist device implantation: role of right heart failure.Journal of thoracic disease · 2023Article
- Left Ventricular Assist Device Pump Obstruction Reduces Native Heart Efficiency.Bioengineering (Basel, Switzerland) · 2023Article
- Article
- The Relation Between Viscous Energy Dissipation and Pulsation for Aortic Hemodynamics Driven by a Left Ventricular Assist Device.Cardiovascular engineering and technology · 2023Article
- Concomitant left atrial appendage closure during left ventricular assist device surgery can reduce ischaemic cerebrovascular accidents.Interdisciplinary cardiovascular and thoracic surgery · 2023Article
- Quantitative Assessment of Aortic Hemodynamics for Varying Left Ventricular Assist Device Outflow Graft Angles and Flow Pulsation.Annals of biomedical engineering · 2023Article
- Neurologic Complications in Patients With Left Ventricular Assist Devices.The Canadian journal of cardiology · 2023Review
- Stroke and pump thrombosis following left ventricular assist device implantation: The impact of the implantation technique.Frontiers in cardiovascular medicine · 2023Article
5 more citing papers are in PubMed but not listed here.
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9 authors.
Funding
Abstract
objectivesThis study sought to evaluate predictors of stroke during left ventricular assist device (LVAD) support from data available prior to implantation, and quantify stroke-related morbidity and mortality.
backgroundStroke is a major complication after LVAD. Pre-implant factors that influence stroke are not well understood.
methodsWe evaluated all patients in INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) who were implanted with continuous flow LVADs from May 1, 2012, to March 31, 2015. Pre-operative risk factors for stroke and stroke incidence, morbidity, and mortality were analyzed.
resultsDuring the study period, 7,112 patients underwent continuous flow LVAD placement. Median follow-up was 9.79 months (range 0.02 to 34.96 months). Of all patients, 752 (10.57%) had at least 1 stroke, with an incidence rate of 0.123 strokes per patient-year. A total of 447 (51.38%) strokes were ischemic and 423 (48.62%) were hemorrhagic. Patients with hemorrhagic stroke had worse survival than those with ischemic strokes (30-day survival: 45.3% vs. 80.7%; p < 0.001). Of patients with a first stroke, 13% had a second stroke. Pre-implant predictors of stroke were female sex (hazard ratio [HR]: 1.51; 95% confidence interval [CI]: 1.25 to 1.82; p < 0.001), pre-implant systolic blood pressure (HR: 1.01; 95% CI: 1.00 to 1.01; p = 0.002), heparin-induced thrombocytopenia (HR: 3.68; 95% CI: 1.60 to 8.47; p = 0.002), intra-aortic balloon pump (HR: 1.21; 95% CI: 1.01 to 1.46; p = 0.043), and primary cardiac diagnosis (ischemic/other/unknown) (p = 0.040).
conclusionsDespite improvements in LVAD technology, stroke-related morbidity and mortality is substantial. Further investigation is necessary to decrease the risk of this devastating complication.
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