Implication of preoperative existence of atrial fibrillation on hemocompatibility-related adverse events during left ventricular assist device support

Teruhiko Imamura, Koichiro Kinugawa, Minoru Ono, Osamu Kinoshita, Norihide Fukushima, Akira Shiose, Yoshiro Matsui, Kenji Yamazaki, Yoshikatsu Saiki, Akihiko Usui, Hiroshi Niinami, Goro Matsumiya, Hirokuni Arai, Yoshiki Sawa

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Abstract

Background: Hemocompatibility-related adverse events (HRAEs) are substantial issues in patients with left ventricular assist devices (LVADs). Atrial fibrillation (AF) is associated with worse prognosis in patients with heart failure (HF), but its effect on HRAEs following LVAD implantation remain uncertain. Methods and Results: Data from the Japanese Mechanically Assisted Circulatory Support registry of consecutive patients who received HeartMate II LVADs and were followed for 1 year were retrospectively reviewed. Among 190 patients, 23 had AF and 167 had sinus rhythm. The AF group had comparable baseline characteristics with the non-AF group except for their higher age (53 vs. 42 years, P<0.001). Following LVAD implantation, most cases of AF (73%) persisted. Antiplatelet therapy, anticoagulation therapy, and LVAD speed following LVAD implantation were comparable between groups (P>0.05 for all). The 1-year survival free from HRAEs was comparable between groups (83% vs. 76%, P=0.52). Event rates of the breakdown of HRAEs were comparable between groups except for a relatively higher rate of surgically managed pump thrombosis in the AF group (0.16 vs. 0.04, incidence rate ratio 3.75, 95% confidence interval 0.87–16.1, P=0.075). These trends still remained with propensity score-matched comparison. Conclusions: Existence of AF had no effect on the development of HRAEs following LVAD implantation. The need to aggressively treat AF before or after LVAD implantation needs further investigation.

Original languageEnglish
Pages (from-to)1286-1292
Number of pages7
JournalCirculation Journal
Volume83
Issue number6
DOIs
Publication statusPublished - Jan 1 2019

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Heart-Assist Devices
Atrial Fibrillation
Propensity Score
Registries
Thrombosis
Heart Failure
Confidence Intervals
Survival
Incidence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Implication of preoperative existence of atrial fibrillation on hemocompatibility-related adverse events during left ventricular assist device support. / Imamura, Teruhiko; Kinugawa, Koichiro; Ono, Minoru; Kinoshita, Osamu; Fukushima, Norihide; Shiose, Akira; Matsui, Yoshiro; Yamazaki, Kenji; Saiki, Yoshikatsu; Usui, Akihiko; Niinami, Hiroshi; Matsumiya, Goro; Arai, Hirokuni; Sawa, Yoshiki.

In: Circulation Journal, Vol. 83, No. 6, 01.01.2019, p. 1286-1292.

Research output: Contribution to journalArticle

Imamura, T, Kinugawa, K, Ono, M, Kinoshita, O, Fukushima, N, Shiose, A, Matsui, Y, Yamazaki, K, Saiki, Y, Usui, A, Niinami, H, Matsumiya, G, Arai, H & Sawa, Y 2019, 'Implication of preoperative existence of atrial fibrillation on hemocompatibility-related adverse events during left ventricular assist device support', Circulation Journal, vol. 83, no. 6, pp. 1286-1292. https://doi.org/10.1253/circj.CJ-18-1215
Imamura, Teruhiko ; Kinugawa, Koichiro ; Ono, Minoru ; Kinoshita, Osamu ; Fukushima, Norihide ; Shiose, Akira ; Matsui, Yoshiro ; Yamazaki, Kenji ; Saiki, Yoshikatsu ; Usui, Akihiko ; Niinami, Hiroshi ; Matsumiya, Goro ; Arai, Hirokuni ; Sawa, Yoshiki. / Implication of preoperative existence of atrial fibrillation on hemocompatibility-related adverse events during left ventricular assist device support. In: Circulation Journal. 2019 ; Vol. 83, No. 6. pp. 1286-1292.
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T1 - Implication of preoperative existence of atrial fibrillation on hemocompatibility-related adverse events during left ventricular assist device support

AU - Imamura, Teruhiko

AU - Kinugawa, Koichiro

AU - Ono, Minoru

AU - Kinoshita, Osamu

AU - Fukushima, Norihide

AU - Shiose, Akira

AU - Matsui, Yoshiro

AU - Yamazaki, Kenji

AU - Saiki, Yoshikatsu

AU - Usui, Akihiko

AU - Niinami, Hiroshi

AU - Matsumiya, Goro

AU - Arai, Hirokuni

AU - Sawa, Yoshiki

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Hemocompatibility-related adverse events (HRAEs) are substantial issues in patients with left ventricular assist devices (LVADs). Atrial fibrillation (AF) is associated with worse prognosis in patients with heart failure (HF), but its effect on HRAEs following LVAD implantation remain uncertain. Methods and Results: Data from the Japanese Mechanically Assisted Circulatory Support registry of consecutive patients who received HeartMate II LVADs and were followed for 1 year were retrospectively reviewed. Among 190 patients, 23 had AF and 167 had sinus rhythm. The AF group had comparable baseline characteristics with the non-AF group except for their higher age (53 vs. 42 years, P<0.001). Following LVAD implantation, most cases of AF (73%) persisted. Antiplatelet therapy, anticoagulation therapy, and LVAD speed following LVAD implantation were comparable between groups (P>0.05 for all). The 1-year survival free from HRAEs was comparable between groups (83% vs. 76%, P=0.52). Event rates of the breakdown of HRAEs were comparable between groups except for a relatively higher rate of surgically managed pump thrombosis in the AF group (0.16 vs. 0.04, incidence rate ratio 3.75, 95% confidence interval 0.87–16.1, P=0.075). These trends still remained with propensity score-matched comparison. Conclusions: Existence of AF had no effect on the development of HRAEs following LVAD implantation. The need to aggressively treat AF before or after LVAD implantation needs further investigation.

AB - Background: Hemocompatibility-related adverse events (HRAEs) are substantial issues in patients with left ventricular assist devices (LVADs). Atrial fibrillation (AF) is associated with worse prognosis in patients with heart failure (HF), but its effect on HRAEs following LVAD implantation remain uncertain. Methods and Results: Data from the Japanese Mechanically Assisted Circulatory Support registry of consecutive patients who received HeartMate II LVADs and were followed for 1 year were retrospectively reviewed. Among 190 patients, 23 had AF and 167 had sinus rhythm. The AF group had comparable baseline characteristics with the non-AF group except for their higher age (53 vs. 42 years, P<0.001). Following LVAD implantation, most cases of AF (73%) persisted. Antiplatelet therapy, anticoagulation therapy, and LVAD speed following LVAD implantation were comparable between groups (P>0.05 for all). The 1-year survival free from HRAEs was comparable between groups (83% vs. 76%, P=0.52). Event rates of the breakdown of HRAEs were comparable between groups except for a relatively higher rate of surgically managed pump thrombosis in the AF group (0.16 vs. 0.04, incidence rate ratio 3.75, 95% confidence interval 0.87–16.1, P=0.075). These trends still remained with propensity score-matched comparison. Conclusions: Existence of AF had no effect on the development of HRAEs following LVAD implantation. The need to aggressively treat AF before or after LVAD implantation needs further investigation.

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JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

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