ArticleAnnals of translational medicine2018
Trends, predictors and outcomes of ischemic stroke and intracranial hemorrhage in patients with a left ventricular assist device.
Article in Annals of translational medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed, 34 citations in OpenAlex.
- Fibrin clot permeability (Ks) in patients on left ventricular assist device.Scientific reports · 2024Article
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- A novel model for hemolysis estimation in rotating impeller blood pumps considering red blood cell aging.Frontiers in physiology · 2023Article
- Observation on the Nursing Effect of the Whole Process in Patients with Severe Intracranial Hemorrhage.Computational and mathematical methods in medicine · 2022Article
- Prothrombin Complex Concentrate for Emergent Reversal of Intracranial Hemorrhage in Patients with Ventricular Assist Devices.Neurocritical care · 2021Article
- Neurocritical Care of Mechanical Circulatory Support Devices.Current neurology and neuroscience reports · 2021Review
- Repetitive Ballistic Movements as a High-Risk Comorbidity in a Ventricular Assist Device Patient.Neurology. Clinical practice · 2021Article
- The Design and Evaluation of a Portable Extracorporeal Centrifugal Blood Pump.Frontiers in physiology · 2021Article
- On the Optimization of a Centrifugal Maglev Blood Pump Through Design Variations.Frontiers in physiology · 2021Article
- Coriolus versicolor polysaccharides (CVP) regulates neuronal apoptosis in cerebral ischemia-reperfusion injury via the p38MAPK signaling pathway.Annals of translational medicine · 2020Article
- Ulinastatin alleviates cerebral ischemia-reperfusion injury in rats by activating the Nrf-2/HO-1 signaling pathway.Annals of translational medicine · 2020Article
- Bleeding in critical care associated with left ventricular assist devices: pathophysiology, symptoms, and management.Hematology. American Society of Hematology. Education Program · 2019Article
- Effects of vitamin K epoxide reductase complex 1 gene polymorphisms on warfarin control in Japanese patients with left ventricular assist devices (LVAD).European journal of clinical pharmacology · 2018Article
- Incidence and impact of ischemic and hemorrhagic stroke after left ventricular assist device implantation: A nationwide study.Indian heart journalArticle
- Risk Factors for Development of Stroke in Patients With Continuous-Flow Left Ventricular Assist Device Support as Destination Therapy.Texas Heart Institute journalArticle
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with a left ventricular assist device (LVAD) are at a higher risk of ischemic stroke (IS) and intracranial hemorrhage (ICH). There is limited data available on risk factors and outcomes associated with IS and ICH in LVAD patients.
methodsAll patients >18 years of age with an LVAD were identified based on the U.S. Nationwide Inpatient Sample (NIS) database from the year 2007 to 2011. Patients with a discharge diagnosis of IS were compared to those without IS. In a separate analysis, patients with a discharge diagnosis of ICH were compared to patients without ICH. Trends, predictors and outcomes of IS and ICH were analyzed using a multivariate regression model.
resultsOut of 17,323 discharges with a primary diagnosis of heart failure with LVAD, 624 (3.6%) patients had a co-diagnosis of IS and 387 (2.2%) had a co-diagnosis of ICH. From 2007 to 2011, the discharge diagnosis of heart failure with LVAD increased from 946 to 5,540, but the proportion of patients with IS remained about 3.4%, while the incidence of ICH decreased from 3.8% in 2007 to a plateau of around 2.2% in the following years. After adjusting for potential confounders, increasing Charlson Comorbidity Index (CCI) score was an independent predictor of IS and ICH. In-hospital mortality was four-fold higher in the IS group (odds ratio: 4.2; 95% CI: 2.3-7.6; P<0.0001) and 18-fold higher in the ICH group (OR: 18; 95% CI: 9-34, P<0.0001). Renal disease (OR: 5.3; CI: 1.3-22.1; P=0.02), liver disease (OR: 4.9; CI: 1.1-21.2; P=0.03) and abnormal coagulation profile (OR: 4.8; CI: 1.6-14.4; P=0.01) were independent predictors of mortality in LVAD patients with IS. Presence of diabetes mellitus (OR 4.3, P=0.1) and liver disease (or 2.8, P=0.2) showed trends towards predicting mortality in LVAD patients with ICH but did not reach statistical significance.
conclusionsIncreasing comorbidity burden significantly increases the risk of both IS and ICH with LVAD. In our cohort, the incidence of IS and ICH increases the mortality 4- and 18-fold, respectively. Renal disease, liver disease and abnormal coagulation profile were independent predictors of mortality in LVAD patients with IS.
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