Heart failure & cardiomyopathies
Concomitant Surgical Procedures and Aspirin Avoidance With Left Ventricular Assist Device Therapy
Authors' conclusion
Our findings support the safety and efficacy of aspirin avoidance from the antithrombotic regimen in HM3 LVAD patients undergoing concomitant surgical procedures.
Study context
- Population
- Patients receiving HeartMate 3 left ventricular assist device (LVAD), with or without concomitant surgical procedures (valvular/CABG or nonvalvular) at implantation589 in primary analysis
- Participants
- 628 patients
- Comparison
- Placebo vs aspirin, with VKA, by concomitant surgical procedure
- Placebon = 296
- Aspirinn = 293reference
- Primary endpoint
- Survival free from major nonsurgical (>14 days postimplant) hemocompatibility-related adverse events
- Follow-up
- 12 months
Methodological detailsprespecified subgroup analysis
- Prespecified subgroup analysis
Primary result
As reported in the abstract
Primary endpoint, by concomitant procedure (subgroup)
No interaction with concomitant procedure: any procedure
Pint = 0.231
No interaction with concomitant procedure: valvular/CABG
0.298
No interaction with concomitant procedure: nonvalvular
0.735
Further findings
Concomitant procedures
Safety
| Outcome | Estimate |
|---|---|
| Nonsurgical major hemorrhagic events, by any concomitant procedure — Placebo vs Aspirin | 0.64 (95% CI 0.44–0.94) |
| Nonsurgical major hemorrhagic events, by any concomitant procedure — Placebo vs Aspirin · without concomitant procedure | 0.66 (95% CI 0.46–0.93) |
- Nonsurgical major hemorrhagic events, by any concomitant procedure: with concomitant procedure (order as printed: with or without)
Nonsurgical major hemorrhagic events, by any concomitant procedure
- Similar reduction with placebo vs aspirin with or without any concomitant procedure
Original publication
Concomitant Surgical Procedures and Aspirin Avoidance With Left Ventricular Assist Device Therapy. JACC Heart Fail. Published 9 April 2025. doi:10.
Summarised from the published abstract; every number is checked against it