Comorbidities and Biomarkers Vary between United States and Japanese LVAD Patients.

Purpose Left ventricular assist device (LVAD) outcomes differ between Japan and US. While GI bleeding is common in US and rare in Japan, stroke and driveline infections are more common in Japan than US. The aim of this study was to explore whether inflammatory and angiogenesis biomarkers can explain these differences. Methods Plasma levels of inflammatory and angiogenetic biomarkers were measured with Bio-plex ProTM Biomarker Assay kits. Levels were compared between US and Japanese LVAD patients. Adverse event rates were also compared between the two countries using binomial negative regression analysis. Results 61 patients were enrolled. The US cohort (N=38) was older (56.4 vs. 42.4 years; p <0.05) and had more women (34% vs. 5%; p <0.05) compared to the Japanese cohort (N=23). Plasma samples were drawn at similar time following LVAD implantation (median 470 vs. 550 days; p=0.68). GIB rate was significantly higher in the US cohort (0.286 vs. 0.023 event/year; p <0.001). Stroke rate (0.052 vs. 0.218 event/year, p <0.001) and driveline infection rate (0.071 vs. 0.184 event/year, p <0.001) were significantly lower in the US cohort. Japanese patients had elevated angiogenesis parameters including 4-fold higher angiopoietin-2 levels (823 vs. 172 pg/mL, p <0.001; Table 1A). Furthermore, Japanese patients had higher markers of inflammation with 4-fold higher IL-8 and 2-fold higher TNF-a (Table 1B). Conclusion Different rate of comorbidities between US and Japan are associated with the different expression of inflammatory and angiogenesis biomarkers. Longitudinal studies focusing on these biomarker levels are warranted. [ABSTRACT FROM AUTHOR]