{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T19:12:23Z","timestamp":1778785943364,"version":"3.51.4"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health\/National Heart Lung and Blood Institute","award":["5K23HL145140"],"award-info":[{"award-number":["5K23HL145140"]}]},{"name":"National Institutes of Health\/National Heart Lung and Blood Institute","award":["R01HL172972"],"award-info":[{"award-number":["R01HL172972"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Observational studies provide a signal that phosphodiesterase-5 inhibitors such as sildenafil are associated with lower mortality and ischaemic stroke during durable left ventricular assist device (LVAD) support. This study aims to determine the causal effects of sildenafil on platelet activation and circulating mediators of vascular remodelling during LVAD support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a double-blind, randomized, placebo-controlled study to determine the effect of sildenafil on platelet activation and circulating mediators of vascular remodelling. Stable participants on LVAD support were assigned to sildenafil or placebo every 8\u2005h for a 15-day period. Three primary endpoints were percent change in platelet activation by collagen, thromboxane (Tx) A2, and adenosine diphosphate (ADP). Secondary endpoints included changes in circulating mediators of vascular remodelling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty participants were randomized. On day 15, those on sildenafil had lower collagen (\u221241%, \u221260 to \u221224, vs. \u22127%, \u221218 to 79, P = .038), but not TxA2 (\u221224%, \u221245 to \u221214 vs. 3%, \u221215 to 87, P = .112), and ADP (\u22125%, \u221270 to 25 vs. 31%, \u221229 to 242, P = .122) induced platelet activation compared to placebo. Endothelin-1 changed by \u221230% (\u221253 to 4) in the sildenafil group vs. \u22123% (\u221218 to 22) with placebo (P = .041). Angiopoietin (ang)-2 changed by \u22125% (\u221211 to \u22124) with sildenafil compared to 3% (\u22125 to 15) with placebo (P = .039), while ang-1 increased by 24% (17\u201354) with sildenafil and was \u22124% (\u221219 to \u22122) with placebo (P = .001), leading to a change in the ang-2\/ang-1 ratio by \u221223% (\u221245 to \u221215) with sildenafil compared to 8% (\u22123 to 24) with placebo (P = .001). Hs-CRP and fibrinogen were unchanged between the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Fifteen days of sildenafil exposure modifies platelet activation and lowers mediators of vascular remodelling on LVAD support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag099","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T11:45:53Z","timestamp":1775130353000},"source":"Crossref","is-referenced-by-count":0,"title":["Effect of sildenafil on platelet activation and mediators of vascular remodelling during LVAD support"],"prefix":"10.1093","volume":"13","author":[{"given":"Omar","family":"Saeed","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine , 3400 Bainbridge Avenue, NewYork, NY 10467 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Snehal R","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Northwell Health , Long Island, NY ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Farooq","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine , 3400 Bainbridge Avenue, NewYork, NY 10467 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0337-7941","authenticated-orcid":false,"given":"Morayma","family":"Reyes Gil","sequence":"additional","affiliation":[{"name":"Department of Pathology, Cleveland Clinic Foundation , Cleveland, OH ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clemencia","family":"Solorzano","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Montefiore Medical Center, Albert Einstein College of Medicine , NewYork, NY ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freda","family":"Afrifa","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Montefiore Medical Center, Albert Einstein College of Medicine , NewYork, NY ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2872-8119","authenticated-orcid":false,"given":"Xiaonan","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health, Albert Einstein College of Medicine , NewYork, NY ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julio Ovalle","family":"Ramos","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine , 3400 Bainbridge Avenue, NewYork, NY 10467 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sasa","family":"Vukelic","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Tulane University , New Orleans, LA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shivank","family":"Madan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine , 3400 Bainbridge Avenue, NewYork, NY 10467 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yogita","family":"Rochlani","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine , 3400 Bainbridge Avenue, NewYork, NY 10467 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandhya","family":"Murthy","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine , 3400 Bainbridge Avenue, NewYork, NY 10467 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel B","family":"Sims","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine , 3400 Bainbridge Avenue, NewYork, NY 10467 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine , 3400 Bainbridge Avenue, NewYork, NY 10467 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel J","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine , NewYork, NY ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Sibinga","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine , 3400 Bainbridge Avenue, NewYork, NY 10467 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karina","family":"Yazdanbakhsh","sequence":"additional","affiliation":[{"name":"NewYork Blood Center , New York, NY 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