Muslem R, et al. - This study assessed the impact of age on renal function and mortality in the first year following left ventricular assist device (LVAD) implantation. For an impaired renal function and mortality, age >60 years was identified as an independent predictor. A cumulative adverse impact of older age plus reduced renal function pre-implantation on post-implantation survival was evident in the findings.

Methods

• In a retrospective multicenter cohort study, all LVAD patients implanted in the 2 participating centers (age ≥18 years) were assessed.
• According the age groups, they were stratified as : <45, 45-54, 55-64, and ≥65 years old.

Results

• This analysis included a total of 241 patients (mean age 52.4±12.9 years, 76% males, 33% destination therapy).
• Findings demonstrated that the mean estimated Glomerular Filtration Rate (eGFR) at 1 year was 85, 72, 69, and 49 mL/min per 1.73m² in the age groups <45(n=65, 27%), 45-54(n=52, 22%), 55-64(n=87, 36%), and ≥65 years (n=37, 15%) p<0.001)), respectively.  
• Data also showed that older age and lower eGFR at baseline (p<0.01) were identified as independent predictors of worse renal function at 1 year.
• Researchers found that the 1-year survival post-implantation was 79%,84%, 68%, and 54% for those in the age group <45, 45-54, 55-64 and ≥65 years (Log-rank p=0.003).
• They identified that older age, lower eGFR and, INTERMACS class I were independent predictors of 1-year mortality.
• Furthermore, data revealed that older patients (age>60 years) with an impaired renal function (eGFR <55 mL/min per 1.73m²) had a 5-fold increased hazard ratio for mortality during the first year after implantation (p<0.001).