TY - JOUR
T1 - Validation of the Minnesota Pectoralis Risk Score to predict mortality in the HeartMate 3 population
AU - Siems, Chesney B.
AU - Ji, Ziyu
AU - Jedeon, Zeina
AU - Schultz, Jessica
AU - Teigen, Levi
AU - Allen, Tadashi
AU - John, Ranjit
AU - Estep, Jerry D.
AU - Masotti, Maria
AU - Alexy, Tamas
AU - Kamdar, Forum
AU - Maharaj, Valmiki
AU - Pritzker, Marc
AU - Garry, Daniel
AU - Shaffer, Andrew
AU - Cogswell, Rebecca
N1 - Publisher Copyright:
© 2023 International Society for the Heart and Lung Transplantation
PY - 2024/4
Y1 - 2024/4
N2 - Background: The Minnesota Pectoralis Risk Score (MPRS) utilizes computed tomography–quantified thoracic muscle and clinical variables to predict survival after left ventricular assist device (LVAD) implantation. The model has not been prospectively tested in HeartMate 3 recipients. Methods: A single-center HeartMate 3 cohort from July 2016 to July 2021 (n = 108) was utilized for this analysis. Cohort subjects with complete covariates for MPRS calculation (pectoralis muscle measures, Black race, creatinine, total bilirubin, body mass index, bridge to transplant status, and presence/absence of contrast) implanted after MPRS development were included. MPRS were calculated on each subject. Receiver operating characteristic curves were generated to test model discrimination at 30-day, 90-day, and 1-year mortality post-LVAD. Next, the performance of the 1-year post-LVAD outcome was compared to the HeartMate 3 survival risk score (HM3RS). Results: The mean age was 58 (15 years), 80% (86/108) were male, and 26% (28/108) were destination therapy. The area under the curve (AUC) for the MPRS model to predict post-LVAD mortality was 0.73 at 30 days, 0.78 at 90 days, and 0.81 at 1 year. The AUC for the HM3RS for the 1-year outcome was 0.693. Each 1-unit point of the MPRS was associated with a significant increase in the hazard rate of death after LVAD (hazard ratio 2.1, 95% confidence interval 1.5-3.0, p < 0.0001). Conclusions: The MPRS had high performance in this prospective validation, particularly with respect to 90-day and 1-year post-LVAD mortality. Such a tool can provide additional information regarding risk stratification to aid informed decision-making.
AB - Background: The Minnesota Pectoralis Risk Score (MPRS) utilizes computed tomography–quantified thoracic muscle and clinical variables to predict survival after left ventricular assist device (LVAD) implantation. The model has not been prospectively tested in HeartMate 3 recipients. Methods: A single-center HeartMate 3 cohort from July 2016 to July 2021 (n = 108) was utilized for this analysis. Cohort subjects with complete covariates for MPRS calculation (pectoralis muscle measures, Black race, creatinine, total bilirubin, body mass index, bridge to transplant status, and presence/absence of contrast) implanted after MPRS development were included. MPRS were calculated on each subject. Receiver operating characteristic curves were generated to test model discrimination at 30-day, 90-day, and 1-year mortality post-LVAD. Next, the performance of the 1-year post-LVAD outcome was compared to the HeartMate 3 survival risk score (HM3RS). Results: The mean age was 58 (15 years), 80% (86/108) were male, and 26% (28/108) were destination therapy. The area under the curve (AUC) for the MPRS model to predict post-LVAD mortality was 0.73 at 30 days, 0.78 at 90 days, and 0.81 at 1 year. The AUC for the HM3RS for the 1-year outcome was 0.693. Each 1-unit point of the MPRS was associated with a significant increase in the hazard rate of death after LVAD (hazard ratio 2.1, 95% confidence interval 1.5-3.0, p < 0.0001). Conclusions: The MPRS had high performance in this prospective validation, particularly with respect to 90-day and 1-year post-LVAD mortality. Such a tool can provide additional information regarding risk stratification to aid informed decision-making.
KW - HeartMate 3
KW - heart failure
KW - left ventricular assist device
KW - medical decision-making
KW - mortality
UR - http://www.scopus.com/inward/record.url?scp=85177871665&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85177871665&partnerID=8YFLogxK
U2 - 10.1016/j.healun.2023.11.003
DO - 10.1016/j.healun.2023.11.003
M3 - Article
C2 - 37956881
AN - SCOPUS:85177871665
SN - 1053-2498
VL - 43
SP - 539
EP - 546
JO - Journal of Heart and Lung Transplantation
JF - Journal of Heart and Lung Transplantation
IS - 4
ER -