Abstract 15984: Black Race and Male Gender Are Protective for Stroke Risk After LVAD: Time for Novel Mechanisms in the Era of Personalized Therapeutics

IntroductionStroke in patients with Left Ventricular Assist Devices (LVAD) is a leading cause of mortality and morbidity, and now is considered one of the major hurdles preventing the application of LVAD technology to the broader population of advanced heart failure. Whilst blood pressure and gender have been previously been identified as risk factors in LVAD patients, little exists on the effect of race on stroke rates in the LVAD population.MethodsWe identified all patients in INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) who were implanted with continuous flow, durable LVADs from 2006 to 2017. Multivariate Cox regression was performed to assess the influence of race and gender on stroke. Cases were censored at loss to follow-up, death, or heart transplantation.ResultsA total of 14573 patients were included in the analysis. There were 3139 Females (21.5%) and 3916 with self-reported black ancestry (26.8%). On adjusted covariate analysis, overall rates of stroke were higher in females compared to males (HR 1.41, 95% CI 1.25-1.59, p