The abstract is read at the publisher; the summary is JClub's.
Obesity in 2,200 HeartMate 3 recipients is linked to higher adjusted risk of the primary endpoint and all-cause mortality, despite similar unadjusted 2-year outcomes.
- Why it matters: BMI-defined obesity and frailty have been associated with worse LVAD outcomes, but it was unclear whether these risks persist with the fully magnetically levitated HM3 pump and how frailty modifies them.
- What they did: Pooled MOMENTUM 3 recipients (515 pivotal, 1,685 continued access) were classified as obese (BMI ≥30 kg/m2) and clinically frail using a 40-item Rockwood FI (FI ≥0.325), then analyzed for survival and morbidity endpoints with covariate adjustment.
- The result: Obese patients had similar unadjusted 2-year freedom from the primary endpoint (75.1% vs 77.1%, P=.34) and survival (79.9% vs 81.2%, P=.57), but adjusted risk increased (primary endpoint HR 1.30, 95% CI 1.07–1.58; mortality HR 1.35, 95% CI 1.10–1.67), while frailty was additive (interaction P=.436) and often improved by 6 months (75.9%), with improved survival (adjusted HR 0.14, 95% CI 0.07–0.26).
The findingWhy it mattersWhat they didThe result
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