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Background: We conducted a single-center, retrospective comparison of adult patients who received warfarin and ASA or warfarin alone after HeartMate 3 (HM3) LVAD placement.

Methods: The primary outcome was a composite of bleeding and thrombotic events.

Results: Of 81 patients, 53 patients received warfarin and ASA, and 28 patients received warfarin alone. A primary outcome event occurred in 22 of 53 patients (41.4%) in the warfarin and ASA group and in 2 of 28 patients (7.1%) in the warfarin alone group (p = 0.0533). The odds of a bleeding event occurring were higher in the warfarin and ASA group (32.1% vs. 7.1%, p = 0.01309). The odds of a thrombotic event occurring were not significantly different between the warfarin and ASA group and the warfarin alone group (9.4% vs. 0%, respectively, p = 0.1582).

Conclusion: The complete omission of ASA from the antithrombotic regimen of patients with a HM3 LVAD was associated with less bleeding events without an increase in thrombotic events.

Titel:	Warfarin and aspirin versus warfarin alone for prevention of bleeding and thrombotic events in patients with a HeartMate 3™ left ventricular assist device.
Autor/in / Beteiligte Person:	Yi, M ; Iyer, P ; Byku, M ; Hollis, IB
Link:	Zum Volltext
Zeitschrift:	Artificial organs, Jg. 48 (2024), Heft 1, S. 98-102
Veröffentlichung:	Cambridge, MA : Wiley-Blackwell ; <i>Original Publication</i>: Cleveland, International Society for Artificial Organs., 2024
Medientyp:	academicJournal
ISSN:	1525-1594 (electronic)
DOI:	10.1111/aor.14652
Schlagwort:	Adult Humans Warfarin adverse effects Aspirin adverse effects Retrospective Studies Hemorrhage chemically induced Hemorrhage prevention & control Heart-Assist Devices adverse effects Thrombosis etiology Thrombosis prevention & control Heart Failure surgery Heart Failure etiology
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Artif Organs] 2024 Jan; Vol. 48 (1), pp. 98-102. <i>Date of Electronic Publication: </i>2023 Sep 27. MeSH Terms: Heart-Assist Devices* / adverse effects ; Thrombosis* / etiology ; Thrombosis* / prevention & control ; Heart Failure* / surgery ; Heart Failure* / etiology ; Adult ; Humans ; Warfarin / adverse effects ; Aspirin / adverse effects ; Retrospective Studies ; Hemorrhage / chemically induced ; Hemorrhage / prevention & control References: Mehra MR, Uriel N, Naka Y, Cleveland JC Jr, Yuzefpolskaya M, Salerno CT, et al. A fully magnetically levitated left ventricular assist device-final report. N Engl J Med. 2019;380(17):1618-1627. ; Nascimbene A, Neelamegham S, Frazier OH, Moake JL, Dong JF. Acquired von Willebrand syndrome associated with left ventricular assist device. Blood. 2016;127(25):3133-3141. ; Kirklin JK, Pagani FD, Goldstein DJ, et al. American Association for Thoracic Surgery/International Society for Heart and Lung Transplantation guidelines on selected topics in mechanical circulatory support. J Heart Lung Transplant. 2020;39:187-219. ; Potapov E, Antonidis C, Crespo-Leiro MG, Combes A, Färber G, Hannan MM, et al. EACTS expert consensus on long-term mechanical circulatory support. Eur J Cardiothorac Surg. 2019;56(2019):230-270. ; Goldstein DJ, John R, Salerno C, Silvestry S, Moazami N, Horstmanshof D, et al. Algorithm for the diagnosis and management of suspected pump thrombus. J Heart Lung Transplant. 2013;32:667-670. ; Slaughter MS, Pagani FD, Rogers JG, Miller LW, Sun B, Russell SD, et al. Clinical management of continuous-flow left ventricular assist devices in advanced heart failure. J Heart Lung Transplant. 2010;29:S1-S39. ; Feldman D, Pamboukian SP, Teuteberg JJ, Birks E, Lietz K, Moore SA, et al. The 2013 International Society for Heart and Lung Transplantation guidelines for mechanical circulatory support: executive summary. J Heart Lung Transplant. 2013;32:157-187. ; Lim HS, Ranasinghe A, Chue C, Mascaro J. Two-year outcome of warfarin monotherapy in HeartMate 3 left ventricular assist device: a single-center experience. J Heart Lung Transplant. 2020;39(10):1149-1151. ; Consolo F, Raimondi Lucchetti M, Tramontin C, Lapenna E, Pappalardo F. Do we need aspirin in HeartMate 3 patients? Eur J Heart Fail. 2019;21(6):815-817. ; The ARIES HeartMate 3 Pump IDE Study. [cited 2022 Oct 31]. Available from: https://clinicaltrials.gov/ct2/show/NCT04069156?term=heartmate+3+and+aspirin-&draw=2&rank=1. Contributed Indexing: Keywords: HeartMate 3 LVAD; aspirin; embolism and thrombosis; heart assist device; hemorrhage; warfarin Substance Nomenclature: 5Q7ZVV76EI (Warfarin) ; R16CO5Y76E (Aspirin) Entry Date(s): Date Created: 20230927 Date Completed: 20231229 Latest Revision: 20231229 Update Code: 20231229

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Warfarin and aspirin versus warfarin alone for prevention of bleeding and thrombotic events in patients with a HeartMate 3™ left ventricular assist device.