Foglieni Chiara, Ravanelli Davide, Lombardi Maria, Spartano Lucia, Pieri Marina, Ajello Silvia, Landoni Giovanni, Scandroglio Anna Mara, Consolo Filippo
Atherosclerosis and Myocardial Disease Laboratory, Cardiovascular Research Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
J Cardiovasc Transl Res. 2025 Jul 11. doi: 10.1007/s12265-025-10659-2.
We tested whether platelet microRNAs (miRs) expression can predict bleeding in patients supported with the HeartMate3 (HM3) left ventricular assist device (LVAD). The levels of expression of platelet miR-126, miR-233, miR-151a, and miR-454 were prospectively measured in 12 consecutive patients pre-implant and during long-term follow-up and compared based on aspirin (ASA) or ASA-free therapy at discharge and bleeding events over the course of HM3 support. Median time of follow-up was 760 (574-844) days. Seven (58%) patients were discharged on ASA and 5 (42%) without ASA. Three (25%) patients experienced 10 bleeding episodes: one never received ASA, and two suffered from bleeding recurrency long after permanent ASA discontinuation. ASA had minimal influence on platelet miRs expression. The expression levels of platelet miR-454 were lower in bleeders vs. non-bleeders, both pre-implant and post-implant. This study suggests the existence of a patient-specific pro-hemorrhagic phenotype associated with a distinctive expression profile of platelet miR-454. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT03255928 . ClinicalTrials.gov Identifier: NCT03255928.
我们测试了血小板微小RNA（miR）的表达是否能够预测接受HeartMate3（HM3）左心室辅助装置（LVAD）支持的患者的出血情况。前瞻性地测定了12例连续患者植入前及长期随访期间血小板miR-126、miR-233、miR-151a和miR-454的表达水平，并根据出院时是否接受阿司匹林（ASA）治疗或无ASA治疗以及在HM3支持过程中的出血事件进行比较。中位随访时间为760（574 - 844）天。7例（58%）患者出院时接受ASA治疗，5例（42%）未接受ASA治疗。3例（25%）患者发生了10次出血事件：1例从未接受过ASA治疗，2例在永久停用ASA后很长时间出现出血复发。ASA对血小板miR表达的影响极小。无论在植入前还是植入后，出血患者的血小板miR-454表达水平均低于未出血患者。本研究表明存在一种与血小板miR-454独特表达谱相关的患者特异性出血倾向表型。临床试验注册：https://clinicaltrials.gov/ct2/show/NCT03255928 。ClinicalTrials.gov标识符：NCT03255928。
