• American heart journal · Feb 2015

    Clinical Trial

    Risk assessment and comparative effectiveness of left ventricular assist device and medical management in ambulatory heart failure patients: design and rationale of the ROADMAP clinical trial.

    • Joseph G Rogers, Andrew J Boyle, John B O'Connell, Douglas A Horstmanshof, Donald C Haas, Mark S Slaughter, Soon J Park, David J Farrar, and Randall C Starling.
    • Division of Cardiology, Duke University, Durham, NC. Electronic address: joseph.rogers@duke.edu.
    • Am. Heart J. 2015 Feb 1;169(2):205-210.e20.

    BackgroundMechanical circulatory support is now a proven therapy for the treatment of patients with advanced heart failure and cardiogenic shock. The role for this therapy in patients with less severe heart failure is unknown.ObjectiveThe objective of this study is to examine the impact of mechanically assisted circulation using the HeartMate II left ventricular assist device in patients who meet current US Food and Drug Administration-defined criteria for treatment but are not yet receiving intravenous inotropic therapy.MethodsThis is a prospective, nonrandomized clinical trial of 200 patients treated with either optimal medical management or a mechanical circulatory support device.Clinical ContextThis trial will be the first prospective clinical evaluation comparing outcomes of patients with advanced ambulatory heart failure treated with either ongoing medical therapy or a left ventricular assist device. It is anticipated to provide novel insights regarding relative outcomes with each treatment and an understanding of patient and provider acceptance of the ventricular assist device therapy. This trial will also provide information regarding the risk of events in "stable" patients with advanced heart failure and guidance for the optimal timing of left ventricular assist device therapy.Copyright © 2014 Elsevier Inc. All rights reserved.

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