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• W2048695098 abstract "The intent of this project is to characterize anticoagulation management strategies and compare clinical outcomes between two international centers. his retrospective cohort included patients implanted with the HeartWare HVAD from 07/01/2009 through 06/1/2012 at site 1 (United States) and from 01/1/2011 through 04/1/2013 at site 2 (Australia). Patients at site 1 were managed at a specialized anticoagultion clinic run by pharmacists and nurses. All patients received aspirin 325 mg daily, had a target INR of 2-3, and were bridged with enoxaparin during periods of sub-therapeutic anticoagulation. At site 2, patients were dosed by their local pathology service. Patients received aspirin 100 mg daily, dipyridamole 100 mg 2-3 times daily, had a target INR of 2-3, and were bridged with enoxaparin. INR values were collected at least monthly. Clinical endpoints, such as bleeding, stroke, and death, were also gathered. At total of 13 patients (mean age 62, 11 male, 8 Caucasian, 7 ischemic etiology, 7 destination therapy) were included from site 1. The mean INR was 2.44±0.52 over 7579 days of follow up. There were 5 bleeding episodes (3 gastrointestinal, 1 epistaxis, 1 hemorragic stroke) and 5 thrombotic events (4 ischemic strokes and 1 device thromobsis) during the study period (0.24 events per patient year for both). At site 1 there were two fatalities (both related to infection) and two transplants; the remaining 9 patients were still alive on support. At site 2, 11 patients (mean age 44, 8 male, 8 Caucasian,1 ischemic etioglogy, all bridge to transplanatation). The mean INR was 2.61 ± 0.56 over 3,999 days of follow up. There were 4 bleeding episodes (1 wound hematomas, 1 hematuria, 1oral, and 1 epistaxis and ocular bleed) and 6 thrombotic events (5 ischemic strokes, 1 deep vein thrombosis, 1 device thrombosis) during the study period (0.37 events per patient year for bleeding and 0.63 events per patient year for thrombosis). There was 1 fatality (related to ischemic stroke), 7 transplants and one device explant; the remaining 4 patients were alive on support. While INR values and antiplatelet strategies were comparable between sites, patient mix and implant strategy differed, as did the rate of thrombotic complications. These data suggest that patient characteristics may be more predictive of thrombotic risk than the intensity of anticoagulation per se." @default.
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• W2048695098 date "2014-04-01" @default.
• W2048695098 modified "2023-09-27" @default.
• W2048695098 title "Anticoagulation for the HeartWare HVAD: An International Comparison of Strategies and Outcomes" @default.
• W2048695098 doi "https://doi.org/10.1016/j.healun.2014.01.848" @default.
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