亲爱的研友该休息了!由于当前在线用户较少,发布求助请尽量完整地填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!身体可是革命的本钱,早点休息,好梦!

Aspirin and Hemocompatibility After LVAD Implantation in Patients With Atherosclerotic Vascular Disease

医学 阿司匹林 冲程(发动机) 经皮冠状动脉介入治疗 临床终点 冠状动脉疾病 传统PCI 内科学 心室辅助装置 心脏病学 安慰剂 外科 随机对照试验 血栓形成 心力衰竭 心肌梗塞 病理 替代医学 工程类 机械工程
作者
Finn Gustafsson,Nir Uriel,Ivan Netuka,Jason N. Katz,Francis D. Pagani,Jean M. Connors,Ulrich P. Jorde,Daniel Zimpfer,Yuriy Pya,Jennifer Conway,Anelechi Anyanwu,Anna Mara Scandroglio,Nasir Sulemanjee,Pavan Atluri,Mary Keebler,Craig H. Selzman,Jeffrey D. Alexis,Chris Hayward,John Henderson,Nicholas Dirckx
出处
期刊:JAMA Cardiology [American Medical Association]
被引量:3
标识
DOI:10.1001/jamacardio.2024.4849
摘要

Importance The Aspirin and Hemocompatibility Events With a Left Ventricular Assist Device in Advanced Heart Failure (ARIES-HM3) study demonstrated that aspirin may be safely eliminated from the antithrombotic regimen after HeartMate 3 (HM3 [Abbott Cardiovascular]) left ventricular assist device (LVAD) implantation. This prespecified analysis explored whether conditions requiring aspirin (prior percutaneous coronary intervention [PCI], coronary artery bypass grafting [CABG], stroke, or peripheral vascular disease [PVD]) would influence outcomes differentially with aspirin avoidance. Objective To analyze aspirin avoidance on hemocompatibility-related adverse events (HRAEs) at 1 year after implant in patients with a history of CABG, PCI, stroke, or PVD. Design, Setting, and Participants This was an international, multicenter, prospective, double-blind, placebo-controlled, randomized clinical trial including patients implanted with a de novo HM3 LVAD across 51 centers. Data analysis was conducted from April to July 2024. Interventions Patients were randomized in a 1:1 ratio to receive aspirin (100 mg per day) or placebo, in addition to a vitamin K antagonist (VKA) targeted to an international normalized ratio of 2 to 3 in both groups. Main Outcomes and Measures Primary end point (assessed for noninferiority) was a composite of survival free of any nonsurgical (>14 days after implant) HRAEs including stroke, pump thrombosis, bleeding, and arterial peripheral thromboembolism at 12 months. Secondary end points included nonsurgical bleeding, stroke, and pump thrombosis events. Results Among 589 of 628 patients (mean [SD] age, 57.1 [13.7] years; 456 male [77.4%]) who contributed to the primary end point analysis, a history of PCI, CABG, stroke, or PVD was present in 41% (240 of 589 patients). There was no interaction between the presence of an atherosclerotic vascular condition and effect of aspirin compared with placebo ( P for interaction= .23). The preset 10% noninferiority margin was not crossed for the studied subgroup of patients. Thrombotic events were rare, with no differences between aspirin and placebo in patients with and without vascular disease ( P for interaction = .77). Aspirin treatment was associated with a higher rate of nonsurgical major bleeding events in the group with prior vascular condition history compared with those without aspirin (rate ratio for placebo compared with aspirin, 0.52; 95% CI, 0.35-0.79). Conclusions and Relevance Results of this prespecified analysis of the ARIES-HM3 randomized clinical trial demonstrate that in patients with advanced heart failure who have classical indications for antiplatelet therapy use at the time of LVAD implantation, aspirin avoidance was safe and not associated with increased thrombosis risk. Importantly, elimination of aspirin was associated with no increased thrombosis but a reduction in nonsurgical bleeding events in patients with a history of PCI, CABG, stroke, or PVD. Trial registration ClinicalTrials.gov Identifier: NCT04069156
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
12秒前
羞涩的傲菡完成签到,获得积分10
21秒前
可耐的冰萍完成签到,获得积分10
22秒前
Dravia完成签到,获得积分10
23秒前
MchemG给年糕的求助进行了留言
28秒前
51秒前
58秒前
菜yoyo完成签到,获得积分10
1分钟前
科研通AI2S应助科研通管家采纳,获得10
1分钟前
小蘑菇应助科研通管家采纳,获得10
1分钟前
隐形曼青应助科研通管家采纳,获得10
1分钟前
Lucas应助科研通管家采纳,获得10
1分钟前
上官若男应助科研通管家采纳,获得10
1分钟前
ktw完成签到,获得积分10
1分钟前
CodeCraft应助Jero采纳,获得10
2分钟前
糖伯虎完成签到 ,获得积分10
2分钟前
Raunio完成签到,获得积分10
2分钟前
2分钟前
Jero发布了新的文献求助10
2分钟前
2分钟前
MchemG应助车哥爱学习采纳,获得10
2分钟前
奋斗雅香完成签到 ,获得积分10
2分钟前
Akim应助啊哦额采纳,获得10
2分钟前
MchemG完成签到,获得积分0
2分钟前
大个应助wao采纳,获得30
2分钟前
Ava应助小杰杰采纳,获得10
3分钟前
3分钟前
大模型应助科研通管家采纳,获得10
3分钟前
bkagyin应助科研通管家采纳,获得20
3分钟前
3分钟前
4分钟前
小杰杰完成签到,获得积分10
4分钟前
小杰杰发布了新的文献求助10
4分钟前
4分钟前
rodrisk完成签到 ,获得积分10
4分钟前
菜yoyo发布了新的文献求助10
4分钟前
4分钟前
Docgyj完成签到 ,获得积分0
5分钟前
5分钟前
5分钟前
高分求助中
【请各位用户详细阅读此贴后再求助】科研通的精品贴汇总(请勿应助) 10000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
International Code of Nomenclature for algae, fungi, and plants (Madrid Code) (Regnum Vegetabile) 500
Maritime Applications of Prolonged Casualty Care: Drowning and Hypothermia on an Amphibious Warship 500
Comparison analysis of Apple face ID in iPad Pro 13” with first use of metasurfaces for diffraction vs. iPhone 16 Pro 500
Towards a $2B optical metasurfaces opportunity by 2029: a cornerstone for augmented reality, an incremental innovation for imaging (YINTR24441) 500
Materials for Green Hydrogen Production 2026-2036: Technologies, Players, Forecasts 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4060942
求助须知:如何正确求助?哪些是违规求助? 3599448
关于积分的说明 11432174
捐赠科研通 3323477
什么是DOI,文献DOI怎么找? 1827290
邀请新用户注册赠送积分活动 897914
科研通“疑难数据库(出版商)”最低求助积分说明 818699