Abstract 17916: Untreated Iron Deficiency is Associated With an Increased Risk for Thrombotic Complications in Patients With Left Ventricular Assist Devices
Introduction: Thrombotic complications are a major cause of morbidity and mortality in LVAD patients. In non-LVAD patients, iron deficiency (ID) is associated with increased risk of thrombotic events including deep vein thrombosis, pulmonary embolism, and stroke.
Hypothesis: ID is associated with an increased risk of LVAD pump thrombosis and stroke in LVAD patients.
Methods: We retrospectively reviewed the records of all adults receiving continuous-flow LVADs at our institution from 2006 to 1/2014 to determine clinical outcomes, iron deficiency status, and iron (parenteral or enteral) treatment status during the first 12 months post-implant. ID was defined as a ferritin <100 mcg/L or ferritin 100-300 mcg/L with transferrin saturation of <20%. LVAD thrombosis and stroke (new, asymptomatic or symptomatic ischemic or hemorrhagic lesions) was defined by INTERMACS criteria. All statistical analysis was performed with SPSS v. 22.0 (Armonk, NY: IBM Corp.).
Results: Of the 205 subjects implanted over the study period, 80 had a complete set of iron studies within the initial 12 months post-implant, and 34 met criteria for ID. Subjects with ID had an increased risk of combined stroke/pump thrombosis (OR 3.04, 95% CI 1.04 – 8.85; p = 0.037) compared to those without ID. Of the subjects with ID, 26 received iron therapy. Untreated subjects had a higher risk for stroke/pump thrombosis when compared to the combined treated and non-ID group (OR 6.9, 95% CI 1.47 – 32.39; p<0.001) (Figure 1).
Conclusions: Untreated ID is associated with an increased risk for thrombotic events during the first 12 months of continuous flow LVAD support.
Author Disclosures: R. Tamrat: None. R. Muslem: None. P. Miller: None. G. Whitman: None. C. Sciortino: None. N.A. Gilotra: None. S.D. Russell: None. R.J. Tedford: None. B.A. Houston: None.
- © 2016 by American Heart Association, Inc.