Heart failure & cardiomyopathiesSecondary analysis
Renin–angiotensin–aldosterone system inhibition and haemocompatibility-related adverse events in patients with durable left ventricular assist devices: the MOMENTUM-3 trial
- Secondary analysis of the MOMENTUM-3 randomised trial
- landmark analysis at 1 month
- multivariable Poisson models
- propensity matching and sustained-exposure sensitivity analyses
Authors' conclusion
In this large clinical trial cohort, RAASi was consistently associated with lower rates of hemocompatibility-related adverse events, driven by reductions in non-surgical bleeding.
Study context
- Population
- Clinically stable recipients of a fully magnetically levitated left ventricular assist device (LVAD) in the MOMENTUM-3 trial portfolio
- Participants
- 1,855 recipients
- Comparison
- Renin-angiotensin-aldosterone system inhibition (RAASi) vs no RAASi at 1 month after LVAD implantation
- Primary endpoint
- Composite HRAEs
- Follow-up
- 2 years
Primary result
As reported in the abstract
Adjusted relative risk
0.83
95% CI 0.75–0.91
P = 0.0001
RAASi vs No RAASi
aRR 0.83 (95% CI 0.75–0.91); P = 0.0001
Further findings
| Outcome | aRR (95% CI) | P value | |
|---|---|---|---|
| Non-surgical bleeding · 2 years | 0.82 (0.73–0.90) | P = 0.0001 | |
| Composite HRAEs, sustained RAASi exposure · 2 years · sustained exposure | 0.67 (0.56–0.80) | P < 0.0001 | |
| 0.512Adjusted relative risk (log scale) |
Composite hemocompatibility-related adverse events (HRAEs) by device platform (HM3 centrifugal, HM II axial)
- Similar effects across HM3 and HM II; independent of mean arterial pressure or anticoagulation intensity
Original publication
Renin–angiotensin–aldosterone system inhibition and haemocompatibility-related adverse events in patients with durable left ventricular assist devices: the MOMENTUM-3 trial. Eur Heart J. Published 10 May 2026. doi:10.1093/eurheartj/ehag386
Summarised from the published abstract; every number is checked against it