Impact of Age on the Utility of CardioMEMs Device to Guide Heart Failure Therapy: Analysis of the National Readmissions Database

Author Type(s)

Faculty, Resident/Fellow

Document Type

Abstract

Publication Date

10-2022

Journal Title

European Heart Journal

Department

Medicine

Abstract

Background

Weeks before patients exhibit signs and symptoms of HF, intracardiac and pulmonary artery pressures increase, offering a potential target for early intervention. The CardioMEMs device is an implantable hemodynamic device placed directly into a branch of the pulmonary artery (PA) which allows remote PA pressure monitoring. The aim of our analysis is to compare outcomes of patients admitted with HF receiving implanted CardioMEMs based on their age. Methods

Data from the National Inpatient Sample (NIS) database from 2014–2019 was used to identify hospitalizations with International Classification of diseases – 9th Revision and International classification of Diseases – 10th Revision procedural codes of patients with heart failure and CardioMEMs implantation. The outcome of interest was readmission rates at 30 days and complications associated with device implantation. Results

We identified 1841 hospitalizations: 708 (38.5%) for patients <65 years-old (mean age 53.6) and 1,113 (60.1%) for patients >65 years-old (mean age 79.5). Gender was similar between the two age cohorts with females representing 36.6% vs 37.7% of the patients (<65 and >65 years old respectively). The cohort of patients >65 years of age had a higher rate of comorbidities including hypertension (87.9% vs 80.2%; p=0.003), prior CABG (20.3% vs 8.5%; p = <0.001), atrial fibrillation (59.2% vs 38.4%; p = <0.001), PPM (10.9%% vs 2.3%; p = <0.001), and ESRD (56.1% vs 47.3%; p=0.015. The presence of LVAD prior to device implantation was higher in the <65-year-old group at 2.8% vs 1.2% (p=0.065). Diabetes, prior PCI, PVD, pulmonary disease, anemia, cancer, and oxygen dependence were similar among the two cohorts and not statistically significant. Complications including acute kidney injury requiring dialysis, stroke, and transplant post CardioMEMs implantation were similar among the two groups. The patients who survived the index hospitalization, readmission rates were significantly improved in the cardioMEMs arm patients who were <65 years of age (13.8% vs 21.9%) compared to those 65 and above (19.6% vs 20.5%), p for interaction <0.001, Figure 1. Conclusion

The CardioMEMS device is more effective in a younger patient population to reduce HF admissions.

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