Abstract 13432: Pulmonary Artery Pressure-Guided Therapy in Patients With Heart Failure Using the CardioMEMS Device and HF Readmissions: Analysis of the National Readmissions Database

Introduction: Pulmonary artery pressure (PAP)-guided therapy in patients with heart failure (HF) using the CardioMEMS device (CMM), an implantable PAP sensor, has shown to reduce hospitalizations in prior studies. Hypothesis: We sought to evaluate the clinical benefit of the CMM device in regard to readmission rates using the National Readmission Database (NRD). Methods: We queried the NRD to identify patients who underwent CMM implantation (CPT code 33289) between years 2014 to 2018 and studied their HF readmissions. We compared CMM patients and their readmissions with a matched cohort of patients with HF without CMM. Multivariate Cox regression analysis was performed to adjust for other predictors of readmissions. Results: Prior to matching we identified 3,965,188 weighted HF patients without CMM and 1528 patients with CMM. After propensity score matching for several patient and hospital related characteristics, the cohort consisted of 1528 patients with CMM and 1528 with HF without CMM. Before matching CMM patients were younger, more frequently males, with higher rates of prior myocardial infarction and chronic kidney disease. Readmission rates at 30-days were 17.6% vs. 21% for patients with vs. without CMM respectively and remained statistically significant after matching (17.5% vs. 22.7%, p=0.01). The rates of 90-day (29.1% vs 36.5%, p=0.002) and 180-day (40.1% vs. 46.6%, p=0.03) readmissions were lower in the CMM group (Figure). In multivariable regression models, CMM was associated with lower risk of readmissions (HR, 0.78, 95% CI 0.64-0.94, p=0.01). Conclusions: The CardioMEMS device was associated with reduced HF rehospitalization rates in a nationally representative cohort of HF patients