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- W2921638531 abstract "Purpose Thromboembolism (TE) is common after left ventricular assist device (LVAD) implantation and early anticoagulation (AC) bridging to therapeutic international normalized ratio (INR) has been widely implemented to prevent this complication. However, some studies suggested that no early AC bridging after LVAD implantation decreases bleeding complications without increase in incidence of TE. This meta-analysis aimed to evaluate the association between early AC bridging after LVAD implantation and incidence of TE and bleeding complications. Methods We performed a comprehensive literature search through September 2018 using MEDLINE and EMBASE. Included studies were prospective or retrospective cohort studies that compared the incidence of TE and bleeding in LVAD patients with and without early AC bridging to therapeutic INR. We calculated pooled odds ratio (OR) with 95% confidence intervals (CI) and I2 statistic using the random-effects model. Results Six studies were included in this meta-analysis. All patients had continuous-flow LVADs implanted. TE events were reported in 6 studies involving 897 patients (611 with bridging, 286 without bridging). Bleeding complications were reported in 4 studies involving 623 patients (405 with bridging, 218 without bridging). Median follow-up was 3.5 months. There was no association between AC bridging and incidence of TE (RR: 0.68; 95% CI: 0.41-1.12, I2=0%) and bleeding complications (RR: 0.98; 95% CI: 0.61-1.57, I2=32%) (Figure). Conclusion Our meta-analysis suggests that early AC bridging to therapeutic INR after LVAD implantation is not associated with decreased TE and increased bleeding complications. Controlled trials are warranted to further investigate the utility of early AC bridging after LVAD implantation in patients at high risk for TE complications." @default.
- W2921638531 created "2019-03-22" @default.
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- W2921638531 date "2019-04-01" @default.
- W2921638531 modified "2023-09-27" @default.
- W2921638531 title "Early Anticoagulation Bridging to Therapeutic International Normalized Ratio after Left Ventricular Assist Device Implantation is Not Associated with Thromboembolic and Bleeding Complications: A Systematic Review and Meta-Analysis" @default.
- W2921638531 doi "https://doi.org/10.1016/j.healun.2019.01.463" @default.
- W2921638531 hasPublicationYear "2019" @default.
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