Women who have advanced heart failure are less likely than men with the condition to receive a potentially life-saving heart pump, according to a study published in Circulation: Heart Failure.
The researchers analyzed data from nearly 30,000 procedures from 2004 to 2016 to implant left ventricular assist devices (LVADs). An LVAD is a mechanical pump that helps a weakened bottom left chamber of the heart keep blood circulating. It’s used either temporarily while a patient with advanced heart failure waits for a heart transplant or longer term to extend life if a patient isn’t eligible for, or chooses not to undergo, a transplant.
Women account for about one-third of all advanced heart failure patients, yet in 2016 theymade up only 22 percent of LVAD recipients, the researchers found. They also discovered that the percentage of implants in women decreased by about 4 percent since 2004.
Prior studies have found that, overall, women have a higher incidence of heart failure than men, but their treatment lags. For example, women are less likely than men to receive drug therapy for their condition (this is also true of coronary heart disease in women).
What else to know
In 2008, new, improved LVADs were introduced. The latest pumps are smaller and more durable than older generation pumps—which had worse outcomes in general and higher death rates in women than in men. The newer LVADs have similar outcomes and death rates in men and women. But some cardiologists may be relying on outdated statistics based on older pumps, say researchers, which steers them away from recommending newer LVADs for women. That might explain why, although doctors have implanted more than 20,000 LVADs in people with heart failure over the past decade, the recipients have been disproportionately men.
What you should do
If your doctor says you’re not eligible for an LVAD, don’t be afraid to ask why. He or she may have valid reasons why you wouldn’t make a good candidate, but you should be given the opportunity to weigh in on any decision and ask follow-up questions. And before you consent to long-term LVAD, make sure you’re fully aware of its risks and benefits.
This article first appeared in the February 2020 issue of UC Berkeley Health After 50.