Risk of pump thrombosis and stroke in patients with continuous-flow left ventricular assist devices and gastrointestinal bleeding

Autor:	Rajko Radovancevic, Marwan F Jumean, Igor D. Gregoric, Brian E. Gulbis, Chandni J. Patel, Thomas W. Szymanski, Mateja Kaja Jezovnik, Biswajit Kar, Sriram Nathan, Phillip Weeks
Rok vydání:	2020
Předmět:	Adult Male Gastrointestinal bleeding medicine.medical_specialty 0206 medical engineering Biomedical Engineering Medicine (miscellaneous) Bioengineering Hemorrhage 02 engineering and technology 030204 cardiovascular system & hematology Biomaterials 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Antithrombotic Clinical endpoint Medicine Humans Stroke Aged Retrospective Studies business.industry Incidence Thrombosis General Medicine Middle Aged medicine.disease 020601 biomedical engineering Heart failure Cardiology Female Heart-Assist Devices business Complication Cohort study
Zdroj:	Artificial organsREFERENCES. 44(11)
ISSN:	1525-1594
Popis:	Gastrointestinal (GI) bleeding is a common complication following the placement of continuous-flow left ventricular assist devices (LVADs) in patients with advanced heart failure. Secondary events arising as a result of GI bleeding have not been well-described. Furthermore, attribution of these events to bleeding is complicated by the interruption or de-intensification of antithrombotic therapy, while bleeding is controlled. The purpose of this study was to assess the incidence of pump thrombosis and ischemic stroke in patients with LVADs who experience GI bleeding, while on support. This was a single-center, retrospective, observational cohort study of consecutive patients with LVADs implanted from January 2012 to June 2018. Patients were assigned to comparator groups based on whether they experienced GI bleeding while on LVAD support. The primary endpoint assessed was the composite of pump thrombosis or ischemic stroke. Secondary endpoints assessed included incidence of pump thrombosis or ischemic stroke. A total of 250 patients were included after screening for exclusion criteria, 101 (40.4%) in the GI bleeding group, and 149 (59.6%) in the non-bleeding group. The incidence of pump thrombosis or ischemic stroke was not significantly greater in patients experiencing GI bleeding [23 (22.8%) vs. 21 (14.1%); P = .09]; however, the incidence of ischemic stroke alone was significantly greater [17 (16.8%) vs. 10 (6.7%); P = .01]. We conclude that GI bleeding in LVAD patients may be associated with a greater risk of ischemic stroke.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a1fc6617d3a766b9f7326bb682ea49e0 https://pubmed.ncbi.nlm.nih.gov/32530086 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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