Heart failure & cardiomyopathiesSecondary analysis
Aspirin and Hemocompatibility After Left Ventricular Assist Device (LVAD) Implantation in Patients With Atherosclerotic Vascular Disease
- Secondary analysis of the ARIES-HM3 randomised trial
- prespecified subgroup analysis
- international
- multicentre
- prospective
- double-blind
- placebo-controlled
- non-inferiority
- Data analysis April to July 2024
Authors' conclusion
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.
Study context
- Population
- Patients with advanced HF implanted with a de novo HM3 LVAD, with vs without prior PCI, CABG, stroke or PVD; 51 centres589 in primary analysis
- Participants
- 628 patients
- Comparison
- Aspirin vs placebo (with vitamin K antagonist (VKA)) after HM3 LVAD implantation, by atherosclerotic vascular disease history
- Primary endpoint
- Survival free of any nonsurgical (>14 days after implant) hemocompatibility-related adverse events (stroke, pump thrombosis, bleeding, arterial peripheral thromboembolism)
- Follow-up
- 12 months
Primary result
As reported in the abstract
Primary end point by history of PCI, CABG, stroke or PVD (41%, 240 of 589)
No interaction between atherosclerotic vascular condition and aspirin vs placebo effect
P for interaction= .23
Secondary outcomes
Thrombotic events, with and without vascular disease
- Rare; no differences between aspirin and placebo
- P for interaction = 0.77
Safety
| Outcome | rate ratio (95% CI) | |
|---|---|---|
| Nonsurgical major bleeding, prior vascular condition subgroup · higher bleeding with aspirin | 0.52 (0.35–0.79) | |
| 0.20.5125Rate ratio (log scale) |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Aspirin and Hemocompatibility After LVAD Implantation in Patients With Atherosclerotic Vascular Disease. JAMA Cardiol. Published 1 March 2025. doi:10.1001/jamacardio.2024.4849
Summarised from the published abstract; every number is checked against it