{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:33:09Z","timestamp":1788546789899,"version":"build-2803163510"},"reference-count":13,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,4,24]],"date-time":"2015-04-24T00:00:00Z","timestamp":1429833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2015,11]]},"abstract":"Abstract<\/jats:title>Left ventricular assist devices (LVADs<\/jats:styled-content>) are associated with hemostatic complications. We describe the incidence and risk factors for gastrointestinal bleeding (GIB<\/jats:styled-content>) and pump thrombosis (PT<\/jats:styled-content>) to optimize patient selection\/management. An IRB<\/jats:styled-content>\u2010approved retrospective review of first LVAD<\/jats:styled-content> implants between October 1, 2011 and September 30, 2013 at a single center was conducted. Endpoints included epidemiological and risk factor analyses for GIB<\/jats:styled-content> and PT<\/jats:styled-content>. Descriptive statistics, chi\u2010squared, and t<\/jats:italic>\u2010tests were used. Sixty\u2010four patients received continuous\u2010flow LVAD<\/jats:styled-content>s. The 12\u2010month incidence of GIB<\/jats:styled-content> and PT<\/jats:styled-content> was 23.4% and 12.5%. Time to first GIB was 72.6 days (9\u2013160). The 1\u2010, 3\u2010, and 6\u2010month rate of PT<\/jats:styled-content> was 1.6%, 6.25%, and 12.5%, respectively. All PT<\/jats:styled-content> required pump exchange. Females (50% vs. 16%, P<\/jats:italic>\u2009=\u20090.026) and patients without antiplatelet therapy (12.5% vs. 50%, P<\/jats:italic>\u2009=\u20090.046) were at increased risk of PT<\/jats:styled-content>. No pre\u2010implant comorbidities were associated with PT<\/jats:styled-content>. Infection was not identified as a risk factor in our cohort (25% vs. 51.8%, P<\/jats:italic>\u2009=\u20090.156). Mean INR<\/jats:styled-content> preceding event was not different from nonevent patients (2.1 vs. 2.24, P<\/jats:italic>\u2009=\u20090.24). Regarding biomarkers preceding event, elevated plasma free hemoglobin (pfHg<\/jats:styled-content>) did not reach significance (75% vs. 58%, P<\/jats:italic>\u2009=\u20090.383) while lactate dehydrogenase was elevated significantly (744 vs. 298, P<\/jats:italic>\u2009<\u20090.001). Receiver operating characteristic (ROC<\/jats:styled-content>) analysis demonstrated that an LDH<\/jats:styled-content> of >500 was highly sensitive and specific for PT<\/jats:styled-content>. No pre\u2010implant factors were associated with GIB<\/jats:styled-content>. Post\u2010implant risk factors for GIB<\/jats:styled-content> included infection (80% vs. 38.8%, P<\/jats:italic>\u2009=\u20090.005) and infrequent elevations in pfHg<\/jats:styled-content> (13.3% vs. 63.3%, P<\/jats:italic>\u2009<\u20090.001). Increased pump speed as a GIB<\/jats:styled-content> risk factor was confirmed (HeartMate II<\/jats:styled-content> 9560\u2009rpm vs. 9490\u2009rpm, P<\/jats:italic>\u2009<\u20090.001; HeartWare 2949\u2009rpm vs. 2710\u2009rpm, P<\/jats:italic>\u2009<\u20090.001). Anticoagulation\/antiplatelet therapy did not affect GIB<\/jats:styled-content>: mean INR<\/jats:styled-content> preceding event was not different from nonevent patients (2.21 vs. 2.27, P<\/jats:italic>\u2009=\u20090.67) and antiplatelet use was not different (46.7% vs. 46.9%, P<\/jats:italic>\u2009=\u20090.985). LVADs<\/jats:styled-content> are associated with early hemostatic\u2010related morbidity. Few pre\u2010implantation risk factors were elucidated; however, post\u2010implantation factors including antiplatelet therapy, infection, and pump speed were identified.<\/jats:p>","DOI":"10.1111\/aor.12471","type":"journal-article","created":{"date-parts":[[2015,4,24]],"date-time":"2015-04-24T20:53:30Z","timestamp":1429908810000},"page":"939-944","source":"Crossref","is-referenced-by-count":46,"title":["Incidence and Risk Factor Analysis for Gastrointestinal Bleeding and Pump Thrombosis in Left Ventricular Assist Device Recipients"],"prefix":"10.1111","volume":"39","author":[{"given":"Alex C.","family":"Lopilato","sequence":"first","affiliation":[{"name":"Department of Pharmacy Tampa General Hospital Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina Teeter","family":"Doligalski","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Tampa General Hospital Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiano","family":"Caldeira","sequence":"additional","affiliation":[{"name":"Florida Advanced Cardiothoracic Surgery Tampa General Hospital Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,4,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2012.10.001"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2014.02.014"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2013.11.001"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2013.12.001"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.06.081"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8191.2010.01025.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2007030308"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1313385"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.07.032"},{"key":"e_1_2_8_11_1","first-page":"849","article-title":"Arteriovenous malformation and gastrointestinal bleeding in patients with the HeartMate II left ventricular assist device","volume":"30","author":"Demirozu Z","year":"2011","journal-title":"J Heart Lung Transpl"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.02.035"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1594.2012.01567.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2013.12.002"}],"container-title":["Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faor.12471","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.12471","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T13:21:35Z","timestamp":1695475295000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aor.12471"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,4,24]]},"references-count":13,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2015,11]]}},"alternative-id":["10.1111\/aor.12471"],"URL":"https:\/\/doi.org\/10.1111\/aor.12471","archive":["Portico"],"relation":{},"ISSN":["0160-564X","1525-1594"],"issn-type":[{"value":"0160-564X","type":"print"},{"value":"1525-1594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,4,24]]}}}