Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
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SHR Neuro Krebs Kardio Lipid Stoffw Microb
Mutschlechner, D; Tscharre, M; Wittmann, F; Kitzmantl, D; Schlöglhofer, T; Wadowski, PP; Laufer, G; Eichelberger, B; Lee, S; Wiedemann, D; Panzer, S; Zimpfer, D; Gremmel, T.
Platelet reactivity is associated with pump thrombosis in patients with left ventricular assist devices
RES PRACT THROMB HAE. 2024; 8(6): 102564
Doi: 10.1016/j.rpth.2024.102564
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- Co-Autor*innen der Med Uni Graz
- Laufer Günther
- Zimpfer Daniel
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- Abstract:
- Background: Patients with left ventricular assist devices (LVADs) are treated with a potent antithrombotic regimen to prevent pump thrombosis and thromboembolism. High on-treatment residual platelet reactivity (HRPR) is associated with ischemic outcomes in cardiovascular disease. Objectives: In the current study, we investigated the prevalence and clinical impact of HRPR in stable LVAD patients. Methods: Pump thrombosis, bleeding events, and death were assessed in 62 LVAD patients (19 HeartWare HVAD [Medtronic] and 43 HeartMate 3 [Abbott]) during a 2-year follow-up. Platelet aggregation was measured by multiple electrode aggregometry, and HRPR was defined as arachidonic acid (AA)-inducible platelet aggregation of >= 21 aggregation units. Soluble P-selectin was determined by enzyme-linked immunosorbent assay. Results: Three patients (4.8%) had pump thrombosis and 10 patients (16.1%) suffered a bleeding complication. AA-inducible platelet aggregation was significantly higher in patients with pump thrombosis (P = .01), whereas platelet aggregation in response to adenosine diphosphate (ADP) and thrombin receptor-activating peptide (TRAP) was comparable between patients without and those with pump thrombosis (both P > .05). Platelet aggregation in response to AA, ADP, and TRAP was similar in patients without and with a bleeding event (all P > .05). HRPR was detected in 29 patients (46.8%) and was associated with significantly higher platelet aggregation in response to AA, ADP, and TRAP as well as higher levels of soluble P-selectin compared with patients without HRPR (all P < .05). All pump thromboses occurred in patients with HRPR (3 vs 0; P = .06) and HVAD. Conclusion: Platelet reactivity is associated with pump thrombosis in LVAD patients. HRPR may represent a risk marker for pump thrombosis, particularly in HVAD patients.
- Find related publications in this database (Keywords)
- bleeding complications
- heart failure
- high on-treatment residual platelet reactivity
- left ventricular
- assist devices
- pump thrombosis