ArticleJACC. Heart failure2015
Clinical outcomes with use of erythropoiesis stimulating agents in patients with the HeartMate II left ventricular assist device.
Article in JACC. Heart failure, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Haemolytic injury and cardiovascular disease.Nature reviews. Cardiology · 2026Review
- Management of Dialysis for Patients Receiving Mechanical Circulatory Support.Journal of the American Society of Nephrology : JASN · 2026Review
- Iron Deficiency in Patients with Left Ventricular Assist Devices.Cardiac failure review · 2024Review
- Epoetin alfa in Pediatric Patients With Ventricular Assist Devices: Is It Safe?The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2022Article
- Endocrine Challenges in Patients with Continuous-Flow Left Ventricular Assist Devices.Nutrients · 2021Review
- Cardiac prostheses-related hemolytic anemia.Clinical cardiology · 2019Review
- Relationship Between Anticoagulation Intensity and Thrombotic or Bleeding Outcomes Among Outpatients With Continuous-Flow Left Ventricular Assist Devices.Circulation. Heart failure · 2016Article
- Anticoagulation management in mechanical circulatory support.Journal of thoracic disease · 2015Review
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11 authors.
Funding
Abstract
objectivesThis study evaluated clinical outcomes associated with erythropoiesis stimulating agent (ESA) use in left ventricular assist devices (LVAD)-supported patients.
backgroundUse of ESAs in patients with LVADs may minimize blood transfusions and decrease allosensitization. ESAs increase thrombotic events, which is concerning because LVADs are sensitive to pump thrombosis (PT).
methodsWe retrospectively reviewed 221 patients at our center who received a HeartMate II (Thoratec Corp., Pleasanton, California) LVAD between January 1, 2009 and June 6, 2013. Patients were divided into those who received ESAs during index admission (n = 121) and those who did not (n = 100). Suspected PT was defined as evidence of thrombus in the LVAD or severe hemolysis (lactate dehydrogenase >1,000 mg/dl or plasma-free hemoglobin >40 mg/dl). Outcomes were compared between cohorts using inverse probability-weighted analyses.
resultsDuring a mean follow-up of 14.2 ± 11.9 months, suspected PT occurred in 37 patients (ESA 23%, no ESA 12%; p =0.03). The ESA cohort received ESAs 13.9 ± 60.9 days after LVAD implantation. At 180 days, event-free rates for suspected PT were ESA 78.6% versus no ESA 94.5% (p < 0.001). ESA use had higher rates of suspected PT (hazard ratio [HR]: 2.35; 95% confidence interval [CI]: 1.38 to 4.00; p = 0.002). For every 100-unit increase in cumulative ESA dosage, the hazard of suspected PT increased by 10% (HR: 1.10; 95% CI: 1.04 to 1.16; p < 0.001). After inverse probability weighting, ESA use was associated with a significantly higher rate of all-cause mortality (HR: 1.62; 95% CI: 1.12 to 2.33; p = 0.01).
conclusionsESA use in LVAD patients is associated with higher rates of suspected PT.
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