Assessment of the Risk Factors for Gastrointestinal Bleeding Among Individuals with Left Ventricular Support Machines
DOI:
https://doi.org/10.56294/mw2024528Keywords:
Gastrointestinal bleeding (GI), thromboembolic (TE), anti-coagulation (AC), co- morbidities, left ventricular assist devices (LVAD)Abstract
Gastrointestinal bleeding is a known complication among individuals with left ventricular support machines, also known as left ventricular assist devices (LVADs). LVADs are mechanical pumps that are used to support the pumping function of the heart in individuals with severe heart failure. To shield patients from thromboembolic intricacies, require anticoagulation (AC) with warfarin and insect platelet treatment. AC or anti-platelet medication is frequently reduced or discontinued in these individuals to address gastrointestinal bleeding (GI), a serious side effect. The likelihood of thromboembolic (TE) events later in LVAD therapy could be affected by changes to AC that are made to control GI bleeding. Provided continuous-flow LVADs to 389 patients, including 308 men, the typical age at implant was 60 years of age. The results were looked at to see if there was a link between GI bleeding and later TEs, which were either suspected or confirmed to be hemolytic, stroke, transient ischemic attack, or pump thrombosis. Using time-dependent variables, the relationships between GI bleeding, subsequent TEs, and mortality were investigated. There were 199 GI draining occasions in 116 of 389 patients, or 0.45 GI drains each quiet year of care. 97 of the 389 patients experienced 128 TE events, or 25% of the total, for a rate of 0.31 TE events per patient-year of assistance. This suggests that a decrease in anticoagulation and anti-platelet therapy for the treatment of GI bleeds could increase this risk, despite the fact that the exact cause of this association is unknown.
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