Heart failure & cardiomyopathiesSecondary analysis
Concomitant Surgical Procedures and Aspirin Avoidance With Left Ventricular Assist Device Therapy
- Secondary analysis of the ARIES-HM3 randomised trial
- prespecified subgroup analysis
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
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:10.1016/j.jchf.2025.01.017
Summarised from the published abstract; every number is checked against it