{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:50:17Z","timestamp":1792183817291,"version":"4.4.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":41,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Five-year survival after continuous-flow left ventricular assist device (LVAD) implantation has improved substantially, resulting in a growing population of ultra-long-term LVAD patients, defined as 5 years and longer survival on LVAD. Remarkably, determinants of mortality beyond the 5-year landmark remain poorly characterized, and ultra-long-term outcomes are rarely investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a large bicentre observational landmark analysis including patients who survived at least 5 years on LVAD support. Implanted devices included HeartMate II, HeartWare (HVAD), and HeartMate 3. Clinical, laboratory, echocardiographic, and haemodynamic parameters at the 5-year time point were evaluated to represent predictors of mortality. Cox proportional hazards regression was used to identify independent predictors of mortality from the 5-year landmark. Model discrimination was assessed using Harrell\u2019s C-index and time-dependent area under the curve.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 201 patients surviving \u22655 years on LVAD support, 189 had complete data for multivariable analysis. Median age at implantation was 59.9 years (IQR 52.6\u201365.8), and 86% were male. During post-landmark follow-up, 77 deaths occurred. Age (HR 1.04 per year, 95% CI 1.02\u20131.07; P = .002), haemoglobin (HR 0.84 per mmol\/l, 95% CI 0.73\u20130.97; P = .016), MELD-XI score (HR 1.10 per unit, 95% CI 1.06\u20131.14; P &amp;lt; .001), and implantable cardioverter-defibrillator presence (HR 1.60, 95% CI 1.00\u20132.54; P = .049) were independently associated with mortality beyond the 5-year landmark. The model showed acceptable discrimination (Harrell\u2019s C-index \u223c0.74). LVAD model was not independently associated with post-landmark mortality (likelihood-ratio P = .63).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among patients who have already survived 5 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag257","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:37:40Z","timestamp":1791286660000},"source":"Crossref","is-referenced-by-count":0,"title":["Predicting survival beyond 5 years on continuous-flow left ventricular assist device: a landmark analysis from the STELLAR registry"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9165-0014","authenticated-orcid":false,"given":"Claudio","family":"Vel\u00e1squez-Silva","sequence":"first","affiliation":[{"name":"Heart Failure Center, Department of Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen (HDZ NRW), University Hospital of the Ruhr-University Bochum , Georgstra\u00dfe 11, 32545 Bad Oeynhausen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William H","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian H","family":"M\u00f8ller","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Copenhagen University Hospital , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasper","family":"Rossing","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1464-239X","authenticated-orcid":false,"given":"Angelika","family":"Costard-J\u00e4ckle","sequence":"additional","affiliation":[{"name":"Heart Failure Center, Department of Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen (HDZ NRW), University Hospital of the Ruhr-University Bochum , Georgstra\u00dfe 11, 32545 Bad Oeynhausen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5803-3575","authenticated-orcid":false,"given":"Ren\u00e9","family":"Schramm","sequence":"additional","affiliation":[{"name":"Heart Failure Center, Department of Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen (HDZ NRW), University Hospital of the Ruhr-University Bochum , Georgstra\u00dfe 11, 32545 Bad Oeynhausen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6178-5791","authenticated-orcid":false,"given":"Michiel","family":"Morshuis","sequence":"additional","affiliation":[{"name":"Heart Failure Center, Department of Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen (HDZ NRW), University Hospital of the Ruhr-University Bochum , Georgstra\u00dfe 11, 32545 Bad Oeynhausen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6956-9110","authenticated-orcid":false,"given":"Jan F","family":"Gummert","sequence":"additional","affiliation":[{"name":"Heart Failure Center, Department of Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen (HDZ NRW), University Hospital of the Ruhr-University Bochum , Georgstra\u00dfe 11, 32545 Bad Oeynhausen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Finn","family":"Gustafsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, University of Copenhagen , Copenhagen ,","place":["Denmark"]},{"name":"Abbott , Chicago, IL 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