LVAD therapy receives a 1A Recommendation from the U.S. joint societies1
The joint committees of the American Heart Association (AHA), American College of Cardiology (ACC), and Heart Failure Society of America (HFSA) recently evaluated the data on LVAD patient outcomes and granted a 1A Recommendation for heart failure patients who are dependent on intravenous inotropes or cannot be weaned from temporary mechanical circulatory support (MCS).
8.4 Mechanical Circulatory Support
“Recommendations for mechanical circulatory support referenced studies that support the recommendations are summarized in the Online Data Supplements”
1A Recommendation is the strongest Class of Recommendation (COR) and the highest level of evidence (LOE). This means that benefits are supported by strong data and far outweigh the risks.
See a Summary of the 1A Recommendation
Inotropes can help heart failure symptoms in the short term but are not a life-saving therapy1,2
For patients with advanced heart failure, the likelihood of long-term survival without an LVAD or a heart transplant is extremely low.1,2
Due to poor outcomes associated with long-term inotrope use when a transplant or LVAD is an option, the American Heart Association (AHA), American College of Cardiology (ACC), and Heart Failure Society of America (HFSA) have issued a 3 Harm recommendation.1 This indicates that the risks of long-term inotrope therapy far outweigh the benefits if a transplant or LVAD if available.1
Patients on long-term inotrope support have a median survival of under a year3
Without an LVAD or transplant, advanced heart failure patients would not be expected to survive beyond 9 months.1,4,*
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Patient Education for Heart Failure
A resource to help patients learn more about heart failure and understand how LVAD therapy can save their life.
*Patients on inotropes who did not receive a transplant or left ventricular assist device.
References
- Writing Committee Members; ACC/AHA Joint Committee Members. 2022 AHA/ACC/HFSA guideline for the management of heart failure. J Card Fail. 2022;28(5):e1-e167
- Sami F, Acharya P, Noonan Q, et al. Palliative inotropes in advanced heart failure: comparing outcomes between milrinone and dobutamine. J Card Fail. 2022;28(12):1683-1691
- Mehra MR, Goldstein DJ, Cleveland JC, et al. Five-Year Outcomes in Patients With Fully Magnetically Levitated vs Axial-Flow Left Ventricular Assist Devices in the MOMENTUM 3 Randomized Trial. JAMA. September 8, 2022. doi:10.1001/jama.2022.16197
- Hashim T, Sanam K, Revilla-Martinez M, et al. Clinical Characteristics and Outcomes of Intravenous Inotropic Therapy in Advanced Heart Failure. Circ Heart Fail. 2015;8(5):880-886
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