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Effect of aspirin dose on hemocompatibility-related outcomes with a magnetically levitated left ventricular assist device: An analysis from the MOMENTUM 3 study.
Saeed, Omar; Colombo, Paolo C; Mehra, Mandeep R; Uriel, Nir; Goldstein, Daniel J; Cleveland, Joseph; Connors, Jean M; Najjar, Samer S; Mokadam, Nahush A; Bansal, Aditya; Crandall, Daniel L; Sood, Poornima; Jorde, Ulrich P.
Afiliación
  • Saeed O; Department of Medicine and Department of Cardiothoracic and Vascular Surgery, Montefiore-Einstein Center for Heart and Vascular Care, Bronx, New York.
  • Colombo PC; Department of Medicine, Columbia University Medical Center, New York, New York.
  • Mehra MR; Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
  • Uriel N; Department of Medicine, Columbia University Medical Center, New York, New York.
  • Goldstein DJ; Department of Medicine and Department of Cardiothoracic and Vascular Surgery, Montefiore-Einstein Center for Heart and Vascular Care, Bronx, New York.
  • Cleveland J; Department of Surgery, University of Colorado Hospital, Aurora, Colorado.
  • Connors JM; Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
  • Najjar SS; Department of Medicine, Medstar Washington Hospital Center, Washington, District of Columbia.
  • Mokadam NA; Department of Surgery, Ohio State University, Columbus, Ohio.
  • Bansal A; Department of Surgery, Ochsner Medical Center, New Orleans, Louisiana.
  • Crandall DL; Division of Cardiology Department of Medicine, Abbott, Chicago, Illinois.
  • Sood P; Division of Cardiology Department of Medicine, Abbott, Chicago, Illinois.
  • Jorde UP; Department of Medicine and Department of Cardiothoracic and Vascular Surgery, Montefiore-Einstein Center for Heart and Vascular Care, Bronx, New York. Electronic address: ujorde@montefiore.org.
J Heart Lung Transplant ; 39(6): 518-525, 2020 06.
Article en En | MEDLINE | ID: mdl-32340871
BACKGROUND: Aspirin (ASA) anti-platelet therapy is mandated with left ventricular assist devices (LVADs) to prevent hemocompatibility-related adverse events (HRAEs). However, the optimal dose of ASA with HeartMate 3 (HM3) LVAD is unknown. METHODS: In an exploratory analysis of HM3-supported patients in the MOMENTUM 3 study (NCT02224755), 2 groups were analyzed: usual-dose (325 mg) and low-dose (81 mg) ASA with anti-coagulation targeted to an international normalized ratio of 2.0 to 3.0. Exclusion criteria included patients not receiving either ASA 81 mg or 325 mg, those with HRAEs ≤7 days after device implantation, and those receiving >1 anti-platelet agent. The primary end-point was survival free from HRAEs (non-surgical bleeding, pump thrombosis, stroke, and peripheral arterial thromboembolic events) at 2 years. RESULTS: Overall, 321 HM3 patients (usual-dose: n = 141, low-dose: n = 180) were included in this analysis. Usual-dose group patients were younger (57 ± 13 vs 60 ± 12 years, p = 0.035) and less often assigned destination therapy (55% vs 67%, p = 0.029) than low-dose ASA. At 2 years, a similar proportion of patients in the usual- and low-dose groups (43.4% vs 45.3%, p = 0.94) met the primary end-point. There were no differences in survival free from hemorrhagic (usual-dose: 54.4% vs low-dose: 51.7%, p = 0.42) or thrombotic (usual-dose: 76.8% vs low-dose: 75.7%, p = 0.92) events. CONCLUSIONS: Usual- and low-dose ASA revealed similar rates of bleeding and thrombotic events in HM3 LVAD-supported patients within the MOMENTUM 3 trial. Whether ASA therapy provides any meaningful therapeutic effect in patients treated by the HM3 LVAD remains to be determined.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trombosis / Aspirina / Corazón Auxiliar / Insuficiencia Cardíaca Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: J Heart Lung Transplant Asunto de la revista: CARDIOLOGIA / TRANSPLANTE Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trombosis / Aspirina / Corazón Auxiliar / Insuficiencia Cardíaca Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: J Heart Lung Transplant Asunto de la revista: CARDIOLOGIA / TRANSPLANTE Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos