Al Asadi Hebe, Abart Theodor, Schwarz Caroline, Moayedifar Roxana, Schaefer Anne-Kristin, Marko Christiane, Messner Barbara, Zimpfer Daniel, Riebandt Julia, Schlöglhofer Thomas
Department of Cardiac Surgery, Medical University of Vienna, 1090 Vienna, Austria.
Ludwig Boltzmann Institute for Cardiovascular Research, 1090 Vienna, Austria.
J Clin Med. 2024 Nov 28;13(23):7234. doi: 10.3390/jcm13237234.
: Patients with a HeartMate 3 (HM3) left ventricular assist device (LVAD) typically receive anticoagulation and antiplatelet therapy. The HM3 has shown a marked reduction in hemocompatibility-related adverse events (HRAEs) like stroke, bleeding, and pump thrombosis. This study evaluated whether aspirin (ASA) response influences HRAE incidence and if ASA sensitivity changes over time in HM3 recipients. : This single-center, cross-sectional study included 32 HM3 patients (age: 59.0 ± 10.0 years, 15.6% female). ASA sensitivity was assessed twice using the VerifyNow assay, with ASA resistance defined by ASA reactivity units (ARU) > 550. The primary endpoint was HRAE incidence in ASA responders vs. non-responders over two consecutive follow-ups; the secondary endpoint was temporal changes in ASA resistance. : At the first follow-up, 13 (40.6%) patients were ASA-resistant, and 8 (28.6%) were resistant at the second follow-up, without significant change ( = 0.22). ASA non-responders and responders had similar ASA doses and baseline characteristics. No significant difference in HRAE incidence was found between ASA non-responders and responders (0.0% vs. 15.8%, = 0.14), and no additional HRAEs occurred during follow-up. : ASA resistance varied considerably among HM3 patients without significant temporal changes, and the demonstrated excellent hemocompatibility supports recent evidence that ASA may have a limited role in the antithrombotic regimen for HM3 recipients.
植入HeartMate 3（HM3）左心室辅助装置（LVAD）的患者通常接受抗凝和抗血小板治疗。HM3在与血液相容性相关的不良事件（HRAEs）如中风、出血和泵血栓形成方面已显示出显著减少。本研究评估了阿司匹林（ASA）反应是否会影响HRAE的发生率，以及在HM3接受者中ASA敏感性是否随时间变化。 ：这项单中心横断面研究纳入了32例HM3患者（年龄：59.0±10.0岁，女性占15.6%）。使用VerifyNow检测法对ASA敏感性进行了两次评估，ASA抵抗定义为ASA反应性单位（ARU）>550。主要终点是连续两次随访中ASA反应者与无反应者的HRAE发生率；次要终点是ASA抵抗的时间变化。 ：在第一次随访时，13例（40.6%）患者存在ASA抵抗，第二次随访时有8例（28.6%）存在抵抗，无显著变化（ =0.22）。ASA无反应者和反应者的ASA剂量和基线特征相似。ASA无反应者和反应者之间的HRAE发生率无显著差异（0.0%对15.8%， =0.14），随访期间未发生额外的HRAEs。 ：在HM3患者中，ASA抵抗差异很大，且无显著的时间变化，所显示的优异血液相容性支持了最近的证据，即ASA在HM3接受者的抗血栓治疗方案中可能作用有限。
