Heart failure & cardiomyopathies
Predicting Survival Beyond 5 Years On Continuous-Flow Left Ventricular Assist Device (LVAD): A Landmark Analysis From The STELLAR Registry
Authors' conclusion
Among patients who have already survived five years on continuous-flow LVAD support, subsequent mortality was associated with routinely available markers of physiological and end-organ reserve. These findings characterize risk specifically in prevalent long-term LVAD recipients and warrant external validation.
Study context
- Population
- Patients who survived at least five years on continuous-flow LVAD support (HeartMate II, HeartWare (HVAD), HeartMate 3)patients surviving ≥5 years on LVAD support, 189 had complete data for multivariable analysis
- Participants
- 201 patients
- Exposure
- Clinical, laboratory, echocardiographic and hemodynamic parameters at the five-year time point as predictors of mortality from the five-year landmark (Cox proportional hazards regression)
- Outcome
- Deaths during post-landmark follow-up
- Follow-up
- Post-landmark
Methodological detailslarge
- Large
Main finding
As reported in the abstract
Deaths
77
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Independent predictors of mortality beyond the five-year landmarkAge | HR 1.04 per year (95% CI 1.02–1.07) | P = 0.002 | |
| Independent predictors of mortality beyond the five-year landmarkHemoglobin | HR 0.84 per mmol/L (95% CI 0.73–0.97) | P = 0.016 | |
| Independent predictors of mortality beyond the five-year landmarkMELD-XI score | HR 1.10 per unit (95% CI 1.06–1.14) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
Independent predictors of mortality beyond the five-year landmark
| HR (95% CI) | P value | ||
|---|---|---|---|
| ICD presence | 1.60 (1.00–2.54) | P = 0.049 | |
| 0.20.5125Hazard ratio (log scale) |
- Independent predictors of mortality beyond the five-year landmark: multivariable analysis (n = 189)
LVAD model and post-landmark mortality
- LVAD model not independently associated with post-landmark mortality
- likelihood-ratio p=0.63
Baseline characteristics
- Median age at implantation
- 59.9 years (IQR 52.6-65.8)
- Male
- 86%
Model discrimination
- Harrell’s C-index (moderate discrimination)
- ≈0.74
Original publication
Predicting Survival Beyond 5 Years On Continuous-Flow LVAD: A Landmark Analysis From The STELLAR Registry. ESC Heart Fail. Published 7 October 2026. doi:10.
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