Antithrombotic Therapy for Individuals with Contemporary Ventricular Assist Devices: Leave Out the Aspirin

A randomized trial shows that avoiding aspirin improves overall outcomes in patients with fully magnetically levitated LVADs.

Although left ventricular assist devices (LVADs) have transformed the outlook for end-stage heart failure with reduced ejection fraction, treatment is associated with adverse consequences, including device thrombosis and associated thromboembolic events. The current guideline recommendations for the use of a combination of vitamin K antagonists and aspirin as antithrombotic therapy in these patients are based upon nonrandomized study data from cohorts with older-generation LVADs. The newer-generation device (HeartMate3), which is fully magnetically levitated, has significantly lowered risks of device thrombosis and stroke (NEJM JW Cardiol Mar 17 2019 and N Engl J Med 2019; 380:1618). In the current manufacturer-funded, double-blind, randomi…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, MACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)

Frederick A. Masoudi, MD, MSPH, MACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)

Antithrombotic Therapy for Individuals with Contemporary Ventricular Assist Devices: Leave Out the Aspirin

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Reviewing Author