Long-Term Medical Treatment and Adherence in Patients With Left Ventricular Assist Devices: A Danish Nationwide Cohort Study

Inge Schjødt*, Rikke E. Mols, Hans Eiskjær, István Bakos, Erzsébet Horváth-Puhó, Finn Gustafsson, Søren L. Kristensen, Johan E. Larsson, Brian B. Løgstrup

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

1 Citationer (Scopus)

Abstract

The use of a left ventricular assist device (LVAD) in treating advanced heart failure has increased. However, data regarding medical treatment and adherence following LVAD implantation is sparse, particularly whether socioeconomic factors (cohabitation status, educational level, employment status, and income) and multimorbidity influence these aspects, which are known to impact adherence in heart failure patients. We performed a nationwide cohort study of 119 patients with LVAD implanted between January 1, 2006, and December 31, 2018, who were discharged alive with LVAD therapy. We linked individual-level data from clinical LVAD databases, the Scandiatransplant Database, and Danish medical and administrative registers. Medical treatment 90-day pre-LVAD and 720-day post-LVAD were assessed using descriptive statistics in 90-day intervals. Medication adherence (proportion of days covered ≥80%) was assessed 181- to 720-day post-LVAD. The proportions of patients using angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (88.7%), beta-blockers (67.0%), mineralocorticoid receptor antagonists (62.9%), warfarin (87.6%), and aspirin (55.7%) within 90-day post-LVAD were higher than pre-LVAD and were stable during follow-up. Medication adherence ranged from 86.7% (aspirin) to 97.8% (warfarin). Socioeconomic factors and multimorbidity did not influence medical medication use and adherence. Among LVAD patients, medical treatment and adherence are at high levels, regardless of socioeconomic background and multimorbidity.
OriginalsprogEngelsk
TidsskriftASAIO Journal
Vol/bind69
Udgave nummer12
Sider (fra-til)E482-E490
Antal sider9
ISSN1058-2916
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
This work was supported by the Karen Elise Jensen’s Foundation (July 2019) and the Helse Foundation (grant number 20-B-0155).

Publisher Copyright:
© 2023 Wolters Kluwer Health, Inc. All rights reserved.

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