AHA: Avoidance of Aspirin Noninferior With LVAD in Advanced Heart Failure

THURSDAY, Nov. 16, 2023 (HealthDay News) -- Avoidance of aspirin as part of an antithrombotic regimen that includes a vitamin K agonist (VKA) is noninferior to an aspirin-containing regimen for patients with advanced heart failure receiving support from a fully magnetically levitated left ventricular assist device (LVAD), according to a study published online Nov. 11 in the Journal of the American Medical Association. The research was published to coincide with the American Heart Association Scientific Sessions 2023, held from Nov. 11 to 13 in Philadelphia.

Mandeep R. Mehra, M.B.B.S., from Brigham and Women's Hospital and Harvard Medical School in Boston, and colleagues examined whether excluding aspirin as part of the antithrombotic regimen with a fully magnetically levitated LVAD is safe and decreases bleeding in an international randomized study of aspirin versus placebo with VKA therapy. A total of 628 patients with advanced heart failure implanted with a fully magnetically levitated LVAD were included in the study; the primary analysis population included 296 and 293 patients in the placebo and aspirin groups, respectively.

The researchers found that more patients were alive and free of hemocompatibility events at 12 months in the placebo group versus the aspirin group (74 versus 68 percent), demonstrating the noninferiority of placebo. A reduction in nonsurgical bleeding events was seen in association with aspirin avoidance (relative risk, 0.66), with no increase in stroke or other thromboembolic events; this finding was consistent across diverse subgroups.

"The benefits of aspirin avoidance are associated with a decrease in hospitalization rates and cost of care due to bleeding complications," the authors write.

Several authors disclosed ties to biopharmaceutical companies, including Abbott, which funded the study.

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