Background
This single‐center, the retrospective study evaluates the impact of preoperative serum prealbumin levels on outcomes after left ventricular assist device (LVAD) implantation.
Methods
Adults undergoing LVAD implantation, with a recorded preoperative prealbumin level, between 2004 to 2018 were included. Primary outcomes included rates of 1‐year survival and secondary outcomes included rates of postimplant adverse events. Threshold regression and restricted cubic splines were utilized to identify a cut‐point to dichotomize prealbumin level. Prealbumin was also evaluated as a continuous variable. Multivariable logistic regression was used for risk‐adjustment.
Results
A total of 333 patients were included. Patients were dichotomized according to an optimal prealbumin threshold of 15 mg/dL: 47.4% (n = 158) had levels below and 52.6% (n = 175) had levels above this threshold, respectively. The rates of postimplant adverse events, including bleeding, infection, stroke, renal failure, and right heart failure, were similar between the groups (all P > .05). Furthermore, the rates of cardiac transplantation and device explantation were also similar (all P > .05). Unadjusted survival was comparable between the groups at 30‐days, 90‐days, and 1‐year following LVAD implantation (all P > .05). In addition, lower prealbumin did not impact risk‐adjusted 1‐year mortality when modeled either as a categorical (OR, 1.08; 95% CI, 0.48‐2.12; P = .82) or continuous variable (OR, 1.99; 95% CI, 0.73‐2.34; P = .96).
Conclusions
This study demonstrates that lower prealbumin levels were not predictive of increased post‐LVAD morbidity or mortality. Although an established marker of nutritional and inflammatory status, the role of prealbumin in patient selection or prognostication appears limited in LVAD patients.