{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T05:30:18Z","timestamp":1786512618993,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Left Ventricular Assist Devices, particularly Heart Mate 3 (HM3), have improved outcomes for advanced heart failure patients. Despite advancements, hemocompatibility\u2010related adverse events (HRAEs) continue to pose significant challenges. Standard antithrombotic therapy combines vitamin K antagonists (VKAs) with aspirin, though the ARIES\u2010HM3 trial showed aspirin avoidance from implantation reduces bleeding without increasing thrombotic events. Whether discontinuing aspirin in stable, long\u2010term HM3 patients is safe remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective single\u2010center study included 44 HM3 recipients maintained on VKA plus low\u2010dose aspirin who underwent aspirin discontinuation while clinically stable. HRAEs, neurological events, nonsurgical bleeding and pump thrombosis, were assessed during two 6\u2010month intervals: pre\u2010 and post\u2010 aspirin withdrawal. Secondary endpoints included individual HRAE components and hemolysis markers (lactate dehydrogenase [LDH] and hemolysis index [HI]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean age at discontinuation was 59.6\u2009\u00b1\u200913.1\u2009years, with median LVAD support duration of 952.5\u2009days. HRAEs occurred in four patients (9.1%) before discontinuation versus three patients (6.8%) after (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.00). Neurological events (2.3% in both periods) and pump thrombosis (2.3% in both periods) were rare. Bleeding declined from 7.0% to 2.3% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.63), with no gastrointestinal bleeding after aspirin discontinuation. LDH remained unchanged (220 vs. 218\u2009U\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.89), while HI rose (Median 3 vs. 5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008) but stayed within normal range.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In long\u2010term, stable HM3 recipients on VKA therapy, aspirin discontinuation did not increase HRAEs. Laboratory markers of hemolysis remained stable aside from a modest, clinically insignificant rise in HI. These findings extend randomized evidence supporting aspirin avoidance at implantation to patients with long\u2010term HM3 support and suggest simplified antithrombotic regimens may be safe in selected HM3 patients. Larger multicenter studies with longer follow\u2010up are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aor.70059","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T12:51:34Z","timestamp":1763643094000},"page":"714-720","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hemocompatibility Outcomes After Aspirin Withdrawal in Long\u2010Term\n                    <scp>HeartMate<\/scp>\n                    3 Left Ventricular Assist Device Patients on Vitamin K Antagonists"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5869-1732","authenticated-orcid":false,"given":"Melanie","family":"Arnreiter","sequence":"first","affiliation":[{"name":"Department of Cardiac and Thoracic Aortic Surgery Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Karner","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Thoracic Aortic Surgery Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hebe Al","family":"Asadi","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Thoracic Aortic Surgery Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina Abd","family":"El\u2010Malak","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Thoracic Aortic Surgery Medical University of Vienna  Vienna Austria"},{"name":"Center for Medical Physics and Biomedical Engineering Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Marko","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Thoracic Aortic Surgery Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Zimpfer","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Thoracic Aortic Surgery Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Riebandt","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Thoracic Aortic Surgery Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana","family":"Moayedifar","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Thoracic Aortic Surgery Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4354-4860","authenticated-orcid":false,"given":"Thomas","family":"Schl\u00f6glhofer","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Thoracic Aortic Surgery Medical University of Vienna  Vienna Austria"},{"name":"Center for Medical Physics and Biomedical Engineering Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2023.11.004"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.028303"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1610426"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.16197"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad658"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx036"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.05.016"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezab474"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13120"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.03.040"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2022.12.004"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2275"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.23204"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2024.4849"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12065"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1515\/CCLM.2009.227"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm-2017-1104"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14070680"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2019.01.028"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2025.07.054"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2022.101506"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2020.06.012"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1468"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000002225"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2020.03.001"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13237234"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1515\/CCLM.2009.218"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2021.11.010"}],"container-title":["Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.70059","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aor.70059","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.70059","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T05:03:08Z","timestamp":1786510988000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aor.70059"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,20]]},"references-count":28,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/aor.70059"],"URL":"https:\/\/doi.org\/10.1111\/aor.70059","archive":["Portico"],"relation":{},"ISSN":["0160-564X","1525-1594"],"issn-type":[{"value":"0160-564X","type":"print"},{"value":"1525-1594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,20]]},"assertion":[{"value":"2025-10-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}