{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,27]],"date-time":"2025-07-27T07:39:00Z","timestamp":1753601940004,"version":"3.38.0"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Appropriate anticoagulation is crucial for the success of left ventricular assist device patients. Currently, there is no consensus on the optimal management of their subtherapeutic INR in ambulatory setting. Our goal is to evaluate both the short\u2010term adverse events and long\u2010term outcomes of enoxaparin bridging at a major transplant center, following the implementation of bridging safety criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In total, 85 patients' medical records were reviewed between 7\/2019 and 5\/2022, with 51 patients meeting safety criteria were bridged with enoxaparin and 34 non\u2010bridged. The primary endpoint was the occurrence of major bleeding\/thrombosis events within 30\u2009days of bridging. The secondary endpoint was freedom from events 30\u2009days after enoxaparin initiation and overall patient survivability until the last follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Within 30\u2009days, no major bleeding\/thrombotic events were noted. After 30\u2009days, the major bleeding rate was 5.8% in bridged vs. 11.8% in non\u2010bridged patients (<jats:italic>p<\/jats:italic>\u2009=\u20090.02). Overall, 3\u2010year survival was 78% in the bridged vs. 49% in non\u2010bridged patients (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In patients with no events, 3\u2010year survival was 80% in bridged vs. 58% in non\u2010bridged (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In the patients with bleeding events, 3\u2010year survival was 55% in bridged vs. 51% in non\u2010bridged (<jats:italic>p<\/jats:italic>\u2009=\u20090.11). At 1\u2009year, freedom from bleeding in the bridged patients was 81% in patients with no events vs. 0% in those with an event (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>When eligibility criteria for safe bridging were applied, the use of enoxaparin bridging was associated with no major bleeding\/thrombotic events during bridging and improved 3\u2010year survival in LVAD patients. Economically, using outpatient enoxaparin resulted in substantial healthcare savings, fewer readmissions, and improved quality of life.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aor.14900","type":"journal-article","created":{"date-parts":[[2024,11,16]],"date-time":"2024-11-16T07:58:11Z","timestamp":1731743891000},"page":"477-485","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of safety criteria for enoxaparin bridging in patients with left ventricular assist devices in an outpatient care setting"],"prefix":"10.1111","volume":"49","author":[{"given":"Lee D.","family":"Lam","sequence":"first","affiliation":[{"name":"Cedars Sinai Comprehensive Transplant Center  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence S.","family":"Czer","sequence":"additional","affiliation":[{"name":"Smidt Heart Institute Cedars Sinai Medical Center  Los Angeles California 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