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Association of thrombophilia prospective detection with hemocompatibility related outcomes in left ventricular assist device patients

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F21%3A00081726" target="_blank" >RIV/00023001:_____/21:00081726 - isvavai.cz</a>

  • Alternative codes found

    RIV/00216208:11120/21:43922180 RIV/00216208:11110/21:10431685 RIV/00216208:11130/21:10431685

  • Result on the web

    <a href="https://journals.sagepub.com/doi/10.1177/03913988211041639" target="_blank" >https://journals.sagepub.com/doi/10.1177/03913988211041639</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.1177/03913988211041639" target="_blank" >10.1177/03913988211041639</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Association of thrombophilia prospective detection with hemocompatibility related outcomes in left ventricular assist device patients

  • Original language description

    Introduction: Inherited thrombophilias represent a concerning risk factor due to a proclivity to an aberrant clot formation. However, in patients with left ventricular assist device (LVAD), their impact on bleeding and thrombotic complications remains still poorly understood. The aim of the present study was to evaluate the effect of thrombophilic mutation directed anticoagulation therapy on adverse clinical outcomes in LVAD patients. Materials and methods: About 138 consecutive patients indicated for LVAD implant (HeartMate II, Abbott, Plymouth, USA) were prospectively screened for three major thrombophilic mutations: factor II (prothrombin), factor V Leiden, and homozygous methylenetetrahydrofolate reductase (MTHFR). Subsequently, discordant individualized anticoagulation targets of INR 2.5-3.0 in thrombophilia positive and INR 1.8-2.2 in negative patients were established; notably without anti-platelet agents given the center standard of care. Results: Mean age was 50 +/- 12.7 years, 83% male. Mean duration of support was 464.5 days (SD 482.9; SEM 41.1) and median of 310 days (IQR 162; 546). Full thrombophilia positive cohort analysis has not revealed any significant impact on event free survival. In contrast, detailed analysis of specific thrombophilias subsets has revealed Factor II prothrombin mutation as a significant predisposition for the pump thrombosis risk (SHR 10.48; p = 0.001) despite more aggressive prespecified anticoagulation target. Moreover, the incidence of bleeding events in prothrombin group was also significantly increased (SHR 6.0; p = 0.03). Conclusions: Our observations suggest that specific thrombophilias in LVAD patients may pose different intensity predisposition for thrombotic complications. Factor II (prothrombin) positive mutation was identified as significant risk factor associated with the pump thrombosis.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30201 - Cardiac and Cardiovascular systems

Result continuities

  • Project

  • Continuities

    N - Vyzkumna aktivita podporovana z neverejnych zdroju

Others

  • Publication year

    2021

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    International journal of artificial organs

  • ISSN

    0391-3988

  • e-ISSN

  • Volume of the periodical

    44

  • Issue of the periodical within the volume

    11

  • Country of publishing house

    US - UNITED STATES

  • Number of pages

    8

  • Pages from-to

    838-845

  • UT code for WoS article

    000700417700001

  • EID of the result in the Scopus database

    2-s2.0-85115653607