Heart failure & cardiomyopathiesCohort study

Predicting Survival Beyond 5 Years On Continuous-Flow Left Ventricular Assist Device (LVAD): A Landmark Analysis From The STELLAR Registry

ESC Heart FailPublished

  • bicenter observational landmark analysis
  • large

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)

Main finding

As reported in the abstract

Deaths during post-landmark follow-up · post-landmark follow-up

Deaths

77

Observational data: associations, not effects.

Further findings

OutcomeEstimateP value
Independent predictors of mortality beyond the five-year landmark — AgeHR 1.04 per year (95% CI 1.02–1.07)P = 0.002
Independent predictors of mortality beyond the five-year landmark — hemoglobinHR 0.84 per mmol/L (95% CI 0.73–0.97)P = 0.016
Independent predictors of mortality beyond the five-year landmark — MELD-XI scoreHR 1.10 per unit (95% CI 1.06–1.14)P < 0.001

Independent predictors of mortality beyond the five-year landmark

ComparisonHR (95% CI)P value
ICD presence1.60 (1.00–2.54)P = 0.049
  • 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)
approximately 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:10.1093/eschf/xvag257

Summarised from the published abstract; every number is checked against it