{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T02:18:22Z","timestamp":1775009902911,"version":"3.50.1"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T00:00:00Z","timestamp":1635120000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Study Objective<\/jats:title><jats:p>This study sought to determine whether SA use is associated with bleeding in patients receiving CF\u2010LVAD support.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A retrospective cohort analysis was conducted of all adult patients who received CF\u2010LVAD implantation at our institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Barnes\u2010Jewish Hospital between July 1, 2009, and October 1, 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Patients at least 18 years of age who received a HVAD\u2122 (HeartWare Corp.), HeartMate II\u2122 (St. Jude Medical), or HeartMate 3\u2122 (St. Jude Medical) CF\u2010LVAD and survived for at least 30 days postoperatively were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>Patients who received SAs (<jats:italic>n<\/jats:italic>\u00a0=\u00a0203) were compared to those who did not (<jats:italic>n<\/jats:italic>\u00a0=\u00a0391) from 30\u00a0days to 18\u00a0months following implantation. The primary outcome was the incidence of first bleeding events including gastrointestinal bleed (GIB), epistaxis, or intracerebral hemorrhage (ICH).<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements and Main Results<\/jats:title><jats:p>During follow\u2010up, 219 patients had bleeding events: 93 of 203 (45.8%) in the SA group versus 126 of 391 (32.2%) in the control group (<jats:italic>p\u00a0<\/jats:italic>=\u00a00.001). After adjustment for age, angiotensin\u2010converting enzyme (ACE) inhibitor and angiotensin receptor blocker (ARB) use, history of bleeding events, history of smoking, and CF\u2010LVAD type, SA use remained associated with bleeding (adjusted odds ratio: 1.75, 95% confidence interval: 1.22\u20132.51, <jats:italic>p\u00a0<\/jats:italic>=\u00a00.002). HeartMate 3\u2122 patients experienced less bleeding than HeartMate II\u2122 patients (adjusted odds ratio 0.46, 95% confidence interval: 0.23\u20130.90, <jats:italic>p\u00a0<\/jats:italic>=\u00a00.024).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this single\u2010center, retrospective cohort of patients supported with CF\u2010LVADs, SA use was associated with the incidence of first bleeding events, primarily driven by GIB. Further studies are needed to assess any differential risk of bleeding among SA agents and to assess the utility of altering antithrombotic strategies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2632","type":"journal-article","created":{"date-parts":[[2021,10,16]],"date-time":"2021-10-16T13:16:06Z","timestamp":1634390166000},"page":"4-13","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association of bleeding with serotonergic antidepressants in patients receiving left ventricular assist device support"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8627-2223","authenticated-orcid":false,"given":"Adam C.","family":"Robinson","sequence":"first","affiliation":[{"name":"Department of Pharmacy Barnes\u2010Jewish Hospital St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5783-5581","authenticated-orcid":false,"given":"Spenser E.","family":"January","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Barnes\u2010Jewish Hospital St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kent W.","family":"Botkin","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Barnes\u2010Jewish Hospital St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin M.","family":"Vader","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases Washington University School of Medicine in Saint Louis St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin C.","family":"Hartupee","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases Washington University School of Medicine in Saint Louis St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bethany R.","family":"Tellor Pennington","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Barnes\u2010Jewish Hospital St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,10,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.12.052"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.03.040"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.02.035"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2016.08.027"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2012.02.015"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.12.014"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.09.041"},{"key":"e_1_2_7_9_1","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/j.healun.2011.03.008","article-title":"Arteriovenous malformation and gastrointestinal bleeding in patients with the HeartMate II left ventricular assist device","volume":"8","author":"Demirozu ZT","year":"2011","journal-title":"J Heart Lung Transplant"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.05.016"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.07.032"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.12.038"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2019.00007"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.117.310848"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2013.10.008"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2007.12.047"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.111.962613"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.019692"},{"key":"e_1_2_7_19_1","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCHEARTFAILURE.118.004899","article-title":"Digoxin is associated with a decreased incidence of angiodysplasia\u2010related gastrointestinal bleeding in patients with continuous\u2010flow left ventricular assist devices","volume":"8","author":"Vukelic S","year":"2018","journal-title":"Circ Heart Fail"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.5301\/ijao.5000650"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.05.015"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.05.037"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.08.002"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.21.2367"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.06.021"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.19.2354"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001200"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2016.4529"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1546"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1734-1140(12)70894-0"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1248\/bpb.31.1371"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i22.3945"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.09r05786blu"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2015.12.025"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.01.467"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2019.07.011"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2015.09.009"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008060"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7314.655"},{"key":"e_1_2_7_40_1","first-page":"E301","article-title":"Outcomes of gastrointestinal bleeding in patients with left ventricular assist devices: a tertiary care experience","volume":"3","author":"Taylor C","year":"2020","journal-title":"Endosc Int Open"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2014.11.008"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.01.027"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2013.12111467"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0b013e31825ccd5a"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2015.07.024"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.011574"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200831020-00005"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2010.240"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1900486"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.01.051"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2016.12.016"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.2632","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/phar.2632","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.2632","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T11:23:14Z","timestamp":1761045794000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.2632"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,25]]},"references-count":50,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1002\/phar.2632"],"URL":"https:\/\/doi.org\/10.1002\/phar.2632","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,25]]},"assertion":[{"value":"2021-07-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}