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(Circulation. 2004;109:e9045-e9046.)
© 2004 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The Neurological Consequences of REMATCH

When the REMATCH (Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure) trial was planned, researchers justifiably focused on comparing long-term treatment with a left ventricular assist device (LVAD) to medical therapy. In this week’s issue of the journal Circulation (Circulation. 2004;109:2423–2427), they look back at the neurological events that struck the study participants. As the researchers, led by Ronald M. Lazar, PhD, of the Columbia University College of Physicians and Surgeons, noted, "Patients in the LVAD arm were significantly more likely to suffer an adverse neurological event than those in the medical arm."

They found that fewer than half the subjects in the group that received an LVAD experienced a neurological event and that there were "few" deaths attributed to neurological causes.

When a survival analysis that combined stroke and death was done, it demonstrated a benefit for the LVAD over medical therapy, yet the researchers warn that future prospective trials need to be done to determine the true risk of neurological events in this patient group as well as the effects on neurocognition and the role of long-term neuroprotection.

A total of 129 patients were assigned randomly to receive either the LVAD or medical treatment. New neurological events were classified as stroke, transient ischemic attack, toxic-metabolic encephalopathy, or other. A total of 46 neurological events were recorded: 42 in 30 patients who received the LVAD and 4 in 4 patients in the medical management group. In other words, 30 patients of the 68 . . . [Full Text of this Article]