PMID- 31809791 OWN - NLM STAT- MEDLINE DCOM- 20210818 LR - 20220729 IS - 1532-8414 (Electronic) IS - 1071-9164 (Print) IS - 1071-9164 (Linking) VI - 26 IP - 4 DP - 2020 Apr TI - Impact of Socioeconomic Factors on Patient Desire for Early LVAD Therapy Prior to Inotrope Dependence. PG - 316-323 LID - S1071-9164(19)31408-3 [pii] LID - 10.1016/j.cardfail.2019.11.026 [doi] AB - BACKGROUND: Worsening heart failure (HF) and health-related quality of life (HRQOL) have been shown to impact the decision to proceed with left ventricular assist device (LVAD) implantation, but little is known about how socioeconomic factors influence expressed patient preference for LVAD. METHODS AND RESULTS: Ambulatory patients with advanced systolic HF (n=353) reviewed written information about LVAD therapy and completed a brief survey to indicate whether they would want an LVAD to treat their current level of HF. Ordinal logistic regression analyses identified clinical and demographic predictors of LVAD preference. Higher New York Heart Association (NYHA) class, worse HRQOL measured by Kansas City Cardiomyopathy Questionnaire, lower education level, and lower income were significant univariable predictors of patients wanting an LVAD. In the multivariable model, higher NYHA class (OR [odds ratio]: 1.43, CI [confidence interval]: 1.08-1.90, P = .013) and lower income level (OR: 2.10, CI: 1.18 - 3.76, P = .012 for <$40,000 vs >$80,000) remained significantly associated with wanting an LVAD. CONCLUSION: Among ambulatory patients with advanced systolic HF, treatment preference for LVAD was influenced by level of income independent of HF severity. Understanding the impact of socioeconomic factors on willingness to consider LVAD therapy may help tailor counseling towards individual needs. CI - Copyright (c) 2019 Elsevier Inc. All rights reserved. FAU - Tchoukina, Inna AU - Tchoukina I AD - Virginia Commonwealth University, Richmond, Virginia. Electronic address: inna.tchoukina@vcuhealth.org. FAU - Shah, Keyur B AU - Shah KB AD - Virginia Commonwealth University, Richmond, Virginia. FAU - Thibodeau, Jennifer T AU - Thibodeau JT AD - University of Texas Southwestern Medical Center, Dallas, Texas. FAU - Estep, Jerry D AU - Estep JD AD - Cleveland Clinic, Cleveland, Ohio. FAU - Lala, Anuradha AU - Lala A AD - Mount Sinai Icahn School of Medicine, New York, New York. FAU - Lanfear, David E AU - Lanfear DE AD - Henry Ford Hospital, Detroit, Michigan. FAU - Gilotra, Nisha A AU - Gilotra NA AD - Johns Hopkins University School of Medicine, Baltimore, Maryland. FAU - Pamboukian, Salpy V AU - Pamboukian SV AD - University of Alabama at Birmingham, Birmingham, Alabama. FAU - Horstmanshof, Douglas A AU - Horstmanshof DA AD - INTEGRIS Baptist Medical Center, Oklahoma City, Oklahoma. FAU - Mcnamara, Dennis M AU - Mcnamara DM AD - University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. FAU - Haas, Donald C AU - Haas DC AD - Abington-Jefferson Health, Abington, Pennsylvania. FAU - Jorde, Ulrich P AU - Jorde UP AD - Montefiore Medical Center, Bronx, New York. FAU - Mclean, Rhondalyn C AU - Mclean RC AD - University of Pennsylvania, Philadelphia, Pennsylvania. FAU - Cascino, Thomas M AU - Cascino TM AD - University of Michigan, Ann Arbor, Michigan. FAU - Khalatbari, Shokoufeh AU - Khalatbari S AD - University of Michigan, Ann Arbor, Michigan. FAU - Richards, Blair AU - Richards B AD - University of Michigan, Ann Arbor, Michigan. FAU - Yosef, Matheos AU - Yosef M AD - University of Michigan, Ann Arbor, Michigan. FAU - Spino, Cathie AU - Spino C AD - University of Michigan, Ann Arbor, Michigan. FAU - Baldwin, J Timothy AU - Baldwin JT AD - National Heart, Lung, and Blood Institute, Bethesda, Maryland. FAU - Mann, Douglas L AU - Mann DL AD - Washington University, St. Louis, Missouri. FAU - Aaronson, Keith D AU - Aaronson KD AD - University of Michigan, Ann Arbor, Michigan. FAU - Stewart, Garrick C AU - Stewart GC AD - Brigham and Women's Hospital, Boston, Massachusetts. CN - REVIVAL Investigators LA - eng GR - HHSN268201100026C/HL/NHLBI NIH HHS/United States GR - R01 HL103871/HL/NHLBI NIH HHS/United States GR - R01 HL132154/HL/NHLBI NIH HHS/United States GR - UL1 TR002240/TR/NCATS NIH HHS/United States PT - Journal Article DEP - 20191204 PL - United States TA - J Card Fail JT - Journal of cardiac failure JID - 9442138 SB - IM MH - *Heart Failure/therapy MH - *Heart-Assist Devices MH - Humans MH - Prospective Studies MH - Quality of Life MH - Socioeconomic Factors MH - Treatment Outcome PMC - PMC7141955 MID - NIHMS1545918 OTO - NOTNLM OT - Ventricular assist device OT - decision-making OT - heart failure OT - socioeconomic status COIS- Disclosures K.B.S. serves as a consultant for Medtronic; J.D.E serves as a medical advisor for Medtronic and as a consultant for Abbott; U.P.J. is a consultant for Abbott; and K.D.A. receives consultant and research support from Medtronic, research support from Abbott, consultant support NuPulseCV and is an advisor to Procyrion. No company had any role in the funding of this study or writing of this article. The other authors report no conflicts. EDAT- 2019/12/07 06:00 MHDA- 2021/08/19 06:00 PMCR- 2021/04/01 CRDT- 2019/12/07 06:00 PHST- 2019/08/08 00:00 [received] PHST- 2019/11/11 00:00 [revised] PHST- 2019/11/26 00:00 [accepted] PHST- 2019/12/07 06:00 [pubmed] PHST- 2021/08/19 06:00 [medline] PHST- 2019/12/07 06:00 [entrez] PHST- 2021/04/01 00:00 [pmc-release] AID - S1071-9164(19)31408-3 [pii] AID - 10.1016/j.cardfail.2019.11.026 [doi] PST - ppublish SO - J Card Fail. 2020 Apr;26(4):316-323. doi: 10.1016/j.cardfail.2019.11.026. Epub 2019 Dec 4.