Association of Angiopoetin-2 and TNF-α With Bleeding During Left Ventricular Assist Device Support: Analysis From the PREVENT Biorepository.

Autor:	Kim G; From the Department of Medicine, University of Chicago, Chicago, Illinois., Sayer G; Department of Medicine, Columbia University, New York, New York., Ransom J; Baptist Health Heart and Transplant Institute, Little Rock, Arkansas., Keebler M; Department Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Katz J; Department of Medicine, Duke University, Durham, North Carolina., Kilic A; Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland., Lindenfeld J; Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee., Egnaczyk G; Christ Hospital, Cincinnati, Ohio., Shah P; Inova Heart and Vascular Institute, Falls Church, Virginia., Brieke A; University of Colorado, Aurora, Colorado., Walenga J; Health Sciences Division, Cardiovascular Research Institute, Loyola University Medical Center, Maywood, Illinois., Crandall D; Abbott (Formerly St Jude Medical), Chicago, Illinois., Farrar DJ; Abbott (Formerly St Jude Medical), Chicago, Illinois., Sundareswaran K; Abbott (Formerly St Jude Medical), Chicago, Illinois., Uriel N; Department of Medicine, Columbia University, New York, New York.
Jazyk:	angličtina
Zdroj:	ASAIO journal (American Society for Artificial Internal Organs : 1992) [ASAIO J] 2023 Aug 01; Vol. 69 (8), pp. 742-748. Date of Electronic Publication: 2023 May 03.
DOI:	10.1097/MAT.0000000000001942
Abstrakt:	The purpose of this study was to describe the changes in plasma levels of angiogenic and inflammatory biomarkers, specifically Ang-2 and TNF-α, in patients receiving HeartMate II (HMII) left ventricular assist device (LVAD) and correlate them with nonsurgical bleeding. It has been shown that angiopoietin-2 (Ang-2) and tissue necrosis factor-α (TNF-α) may be linked to bleeding in LVAD patients. This study utilized biobanked samples prospectively collected from the PREVENT study, a prospective, multicenter, single-arm, nonrandomized study of patients implanted with HMII. Paired serum samples were obtained in 140 patients before implantation and at 90 days postimplantation. Baseline demographics were as follows: age 57 ± 13 years, 41% had ischemic etiology, 82% male, and 75% destination therapy indication. In the 17 patients with baseline elevation of both TNF-α and Ang-2, 10 (60%) experienced a significant bleeding event within 180 days postimplant compared with 37 of 98 (38%) patients with Ang-2 and TNF-α below the mean ( p = 0.02). The hazard ratio for a bleeding event was 2.3 (95% CI: 1.2-4.6) in patients with elevated levels of both TNF-α and Ang-2. In the PREVENT multicenter study, patients with elevations in serum Angiopoietin-2 and TNF-α at baseline before LVAD implantation demonstrated increased bleeding events after LVAD implantation. Competing Interests: Disclosure: G.S. and A.K. received consulting from Abbott. J.L. received consulting from Novartis, Abbott, Resmed, Edwards, VWave, Impulse Dynamics, and CVRx. G.E. received consulting from Abbott. P.S. received grant support from Medtronic, and Abbott and consulting from NuPulse CV. Jeanine Walenga: received grant support from Abbott. D.C., D.F., and K.S. are the employees of Abbott. Nir Uriel received consulting from Abbott. The other authors have no conflicts of interest to report. (Copyright © ASAIO 2023.)
Databáze:	MEDLINE
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