HeartMate 3 superior to HeartMate II whether device is bridge to transplant or destination therapy
WEDNESDAY, Jan. 15, 2020 (HealthDay News) — For patients with advanced heart failure, the HeartMate 3 (HM3) left ventricular assist device (LVAD) is superior to the HeartMate II (HMII), regardless of whether the device is a bridge to transplant (BTT) or a destination therapy (DT), according to a study published online Jan. 15 in JAMA Cardiology.
Daniel J. Goldstein, M.D., from the Montefiore Einstein Center for Heart and Vascular Care in New York City, and colleagues conducted a prespecified secondary analysis of a randomized clinical trial comparing the magnetically levitated centrifugal-flow HM3 LVAD to the mechanical-bearing axial-flow HMII pump in 69 centers. A total of 1,020 patients with advanced heart failure were randomly assigned to an LVAD (515 to HM3 devices and 505 to HMII devices), regardless of the intended goal of therapy (BTT or bridge to transplant candidacy [BTC] versus DT).
Of the 1,020 patients, 38.8 and 61.2 percent were in the BTT/BTC and DT groups, respectively. The researchers found that HM3 use was superior to HMII use for survival free of disabling stroke and reoperation among patients in the BTT/BTC group (76.8 versus 67.3 percent; hazard ratio, 0.62) and in the DT group (73.2 versus 58.7 percent; hazard ratio, 0.61).
“The use of DT or BTT/BTC designations based on current or uncertain future transplant eligibility is not necessary,” the authors write. “Patients with medically refractory heart failure can be successfully treated under a single preimplant strategy with the goal of extending survival and improving quality of life.”
Several authors disclosed financial ties to biopharmaceutical companies, including Abbott Laboratories, which funded the study.
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