HeartMate 3 and HVAD systems demonstrated similar on-treatment platelet activation and aggregation (all p > 0.05), though HVAD patients had significantly lower VWF activity (p = 0.011).
Observational (n=59)
Does the HeartMate 3 LVAD compared to the Heartware HVAD alter platelet activation and aggregation in patients with end-stage heart failure?
While platelet activation and aggregation are similar between HM3 and HVAD, HVAD is associated with lower VWF activity and reduced large VWF multimers, which may have clinical implications for thrombogenicity.
p-value: p=>.05
Left-ventricular assist devices (LVADs) improve outcomes in end-stage heart failure patients. Two centrifugal-flow LVAD systems are currently approved, HeartMate 3 (HM3) and Medtronic/Heartware HVAD (HVAD). Clinical findings suggest differences in thrombogenicity between both systems. We compared markers of platelet activation and aggregation between HM3 and HVAD. We prospectively included 59 LVAD patients (40 HM3, 19 HVAD). Platelet P-selectin expression, activated glycoprotein (GP) IIb/IIIa and monocyte-platelet aggregates (MPA) were assessed by flow-cytometry. Platelet aggregation was measured by light-transmission aggregometry (LTA) and multiple-electrode aggregometry (MEA). Von-Willebrand factor (VWF) antigen (VWF:Ag), VWF activity (VWF:Ac), and VWF multimer pattern analysis were determined. Soluble P-selectin (sP-selectin) was measured with an enzyme-linked immunoassay. P-selectin, GPIIb/IIIa and MPA levels in vivo and in response to arachidonic acid, adenosine diphosphate, and thrombin receptor activating peptide were similar between HM3 and HVAD (all p > .05). Likewise, agonist-inducible platelet aggregation by LTA and MEA did not differ between HM3 and HVAD (all p > .05). VWF:Ag levels and FVIII:C were similar between both systems (both p > .05), but patients with HVAD had significantly lower VWF:Ac (p = .011) and reduced large VWF multimers (p = .013). Finally, sP-selectin levels were similar in patients with HVAD and HM3 (p = .845). In conclusion, on-treatment platelet activation and aggregation are similar in HM3 and HVAD patients. Potential clinical implications of observed differences in VWF profiles between both LVAD systems need to be addressed in future clinical trials.
Tscharre et al. (Wed,) conducted a observational in End-stage heart failure (n=59). HeartMate 3 (HM3) left ventricular assist device vs. Medtronic/Heartware HVAD was evaluated on Markers of platelet activation and aggregation (p=>.05). HeartMate 3 and HVAD systems demonstrated similar on-treatment platelet activation and aggregation (all p > 0.05), though HVAD patients had significantly lower VWF activity (p = 0.011).