Key result
A low pulsatility index (<4.15) was independently associated with an increased hazard of overt gastrointestinal bleeding in HeartMate II recipients (overall event rate 18%).
Why the study?
Does a low pulsatility index increase the hazard of overt gastrointestinal bleeding in patients with HeartMate II CF-LVADs?
Cohort (n=95)
No
Does a low pulsatility index increase the hazard of overt gastrointestinal bleeding in patients with HeartMate II CF-LVADs?
Answers are grounded in this paper and cite their sources.
In patients with HeartMate II continuous-flow left ventricular assist devices, a lower pulsatility index is independently associated with an increased risk of overt gastrointestinal bleeding.
Gastrointestinal bleeding (GIB) is common in patients with continuous-flow left ventricular assist devices (CF-LVADs) possibly because of changes in blood flow. We aimed to test the hypothesis that a low pulsatility index (PI) is associated with an increased hazard of overt GIB in patients with CF-LVADs. We conducted a retrospective cohort study of patients who had a HeartMate II (HMII) CF-LVAD implanted at our center. The study end-point was the first overt GIB causing or occurring during a hospitalization between 6 days and 6 months after HMII implantation. HMII PI was recorded at 48 hours and at 1, 3, and 6 month intervals after implantation. We analyzed the associations of PI and clinical variables with the hazard of overt GIB. Ninety-five patients met eligibility criteria. PI ranged from 2.5 to 5.9 (low PI < 4.15 and high PI ≥ 4.15 on the basis of receiver operating characteristic curve analysis). Seventeen (18%) patients experienced overt GIB. In a multivariable model, only lower baseline hemoglobin was a significant predictor of an increased hazard of overt GIB. After adjusting for the baseline hemoglobin, low PI was independently associated with an increased hazard of overt GIB in our cohort of HMII recipients.
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Edwards et al. (2018) conducted a cohort in HeartMate II continuous-flow left ventricular assist device recipients (n=95). Low pulsatility index (PI < 4.15) vs. High pulsatility index (PI ≥ 4.15) was evaluated on First overt gastrointestinal bleeding causing or occurring during a hospitalization between 6 days and 6 months after implantation. A low pulsatility index (<4.15) was independently associated with an increased hazard of overt gastrointestinal bleeding in HeartMate II recipients (overall event rate 18%).
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