Predictors of Thromboembolic Events in Patients with Ventricular Assist Device

Academic Article

Abstract

  • Ventricular assist device patients (VAD) are at increased risk for thromboembolism. Biomarkers of hemolysis, such as lactate dehydrogenase (LDH) and poorly controlled INR has been identified as predictors of thromboembolism.Patients aged 19 years and older who had a continuous flow VAD placed from 2006-2012 were included in this study (N=115). We assessed the relationship of LDH elevation (> 600 IU/L) at different time points and thromboembolism. Over the 51.3 person-years of follow-up, a total of 23 first thromboembolic events occurred. Patients with elevated LDH on the day of VAD implantation had an increased risk for thromboembolism (HR 4.72, 95% CI 1.44-15.4, p=0.01). There was an increased risk of thromboembolism with early LDH elevation within the first month post VAD (HR 4.95, 95%CI 1.69-14.4, p=0.003) and eGFR <30 prior to VAD implantation (HR 4.74, 95%CI 1.12-20.1, p=0.0346) while there was a decreased risk with good anticoagulation control (HR 0.30, 95%CI 0.10-0.86, p=0.0247).
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    Author List

  • Boehme AK; Pamboukian SV; George JF; Dillon C; Levitan EB; Griffin R; Beasley TM; McGwin G; Kirklin JK; Limdi NA