Key result
Sustained thrombocytopenia, increased mean platelet volume, and elevated sCD40L predicted one-year gastrointestinal bleeding and mortality in 61 patients following first-time LVAD implantation.
Why the study?
It was unknown whether baseline analysis and early trends in routine laboratory data, platelet activity, and thromboinflammatory biomarkers after LVAD implantation could predict personalized risks of 1-year adverse events and mortality.
Do early trends in routine laboratory data, platelet activity, and thromboinflammatory biomarkers predict one-year adverse events in patients undergoing first-time LVAD implantation?
Observational (n=61)
No
Do early trends in routine laboratory data, platelet activity, and thromboinflammatory biomarkers predict one-year adverse events in patients undergoing first-time LVAD implantation?
Early trends in routine bloodwork, platelet function, and thromboinflammatory biomarkers like sCD40L may serve as novel signatures for personalized risk-stratification of bleeding and mortality in patients on LVAD support.
May inform early LVAD risk stratification; leaves open prospective validation before clinical adoption.
Background: Left ventricular assist devices (LVADs) provide support for patients with end-stage heart failure. The aims of this study were to determine whether baseline analysis and early trends in routine laboratory data, platelet activity, and thromboinflammatory biomarkers following LVAD implantation reveal trends that predict personalized risks of one-year gastrointestinal (GI) bleeding, stroke, pump thrombosis, drive-line infections and mortality in patients on LVAD support.Methods: We performed an observational study at the University of Kentucky with 61 participants who underwent first-time LVAD implantation. Blood was collected at baseline and post-op days 0, 1, 3 and 6 as well as clinical follow-up. Demographics, clinical characteristics, one-year adverse events and routine laboratory data were collected from electronic medical records. Platelet function and plasma biomarkers were profiled.Results: Evaluation of routine laboratory results revealed that sustained thrombocytopenia and increased mean platelet volume (MPV) were associated with development of GI bleeding and mortality. Platelet function at follow-up visit predicted one-year bleeding events. Thrombotic biomarker sCD40L strongly predicted one-year GI bleeding at baseline before implantation and within the first week following LVAD implant.Conclusions: Early trends in routine bloodwork and platelet function may serve as novel signatures of patients at risk to experience adverse events.
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Shrout et al. (2019) conducted an observational in end-stage heart failure (n=61). Early trends in routine laboratory data, platelet activity, and thromboinflammatory biomarkers was evaluated on one-year gastrointestinal (GI) bleeding, stroke, pump thrombosis, drive-line infections and mortality. Sustained thrombocytopenia, increased mean platelet volume, and elevated sCD40L predicted one-year gastrointestinal bleeding and mortality in 61 patients following first-time LVAD implantation.
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