{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T22:34:17Z","timestamp":1784068457543,"version":"3.55.0"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,4,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Prior studies have shown that women have worse 3\u2010month survival after receiving a left ventricular assist device compared with men. Currently used prognostic scores, including the Heartmate II Risk Score, do not account for the increased residual risk in women. We used the IMACS (International Society for Heart and Lung Transplantation Mechanically Assisted Circulatory Support) registry to create and validate a sex\u2010specific risk score for early mortality in left ventricular assist device recipients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Adult patients with a continuous\u2010flow LVAD from the IMACS registry were randomly divided into a derivation cohort (DC; n=9113; 21% female) and a validation cohort (VC; n=6074; 21% female). The IMACS Risk Score was developed in the DC to predict 3\u2010month mortality, from preoperative candidate predictors selected using the Akaike information criterion, or significant sex\u00a0\u00d7\u00a0variable interaction. In the DC, age, cardiogenic shock at implantation, body mass index, blood urea nitrogen, bilirubin, hemoglobin, albumin, platelet count, left ventricular end\u2010diastolic diameter, tricuspid regurgitation, dialysis, and major infection before implantation were retained as significant predictors of 3\u2010month mortality. There was significant ischemic heart failure\u00a0\u00d7\u00a0sex and platelet count\u00a0\u00d7\u00a0sex interaction. For each quartile increase in IMACS risk score, men (odds ratio [OR], 1.86; 95% CI, 1.74\u20132.00;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001), and women (OR, 1.93; 95% CI, 1.47\u20132.59;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001) had higher odds of 3\u2010month mortality. The IMACS risk score represented a significant improvement over Heartmate II Risk Score (IMACS risk score area under the receiver operating characteristic curve: men: DC, 0.71; 95% CI, 0.69\u20130.73; VC, 0.69; 95% CI, 0.66\u20130.72; women: DC, 0.73; 95% CI, 0.70\u20130.77; VC, 0.71 [95% CI, 0.66\u20130.76;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01 for improvement in receiver operating characteristic) and provided excellent risk calibration in both sexes. Removal of sex\u2010specific interaction terms resulted in significant loss of model fit.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">A sex\u2010specific risk score provides excellent risk prediction in LVAD recipients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.020019","type":"journal-article","created":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T09:51:01Z","timestamp":1616665861000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Creation and Validation of a Novel Sex\u2010Specific Mortality Risk Score in LVAD Recipients"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6986-0987","authenticated-orcid":false,"given":"Aditi","family":"Nayak","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Medicine Emory Clinical Cardiovascular Research InstituteEmory University School of Medicine Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4171-8716","authenticated-orcid":false,"given":"Yingtian","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Rollins School of Public Health Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6543-9765","authenticated-orcid":false,"given":"Yi\u2010An","family":"Ko","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Emory Clinical Cardiovascular Research InstituteEmory University School of Medicine Atlanta GA"},{"name":"Department of Biostatistics and Bioinformatics Rollins School of Public Health Emory University Atlanta 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AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L.","family":"Kormos","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery University of Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Cowger","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Department of Medicine Henry Ford Hospital Detroit MI"},{"name":"Department of Internal Medicine Wayne State University Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3080-3675","authenticated-orcid":false,"given":"Marc A.","family":"Simon","sequence":"additional","affiliation":[{"name":"Departments of Medicine (Division of Cardiology) and Bioengineering Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute McGowan Institute for Regenerative MedicineClinical and Translational Science InstituteUniversity of Pittsburgh PA"},{"name":"Heart 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