{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T19:27:06Z","timestamp":1762543626859,"version":"build-2065373602"},"reference-count":19,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:00:00Z","timestamp":1653350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T35 grant"],"award-info":[{"award-number":["T35 grant"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Cardiac Surgery"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>The role of thromboelastography (TEG) in managing antiplatelet therapy (APT) in left ventricular assist devices (LVADs) is controversial. Our aim was to determine whether removal of TEG from an LVAD\u2010specific APT protocol reduced late\u2010onset bleeding without increasing thromboembolic complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a single\u2010center, retrospective cohort study including all recipients of a continuous\u2010flow LVAD between April 2005 and November 2019 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009293). LVAD recipients before June 1, 2017 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009221) whose APT was monitored and adjusted using TEG were compared with LVAD recipients after June 1,\u00a02017 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200972) where TEG was not utilized. Occurrence of late\u2010onset bleeding events after postoperative Day 7 and thromboembolic events were collected. APT doses, warfarin use and International normalized ratio (INR) values were collected at discharge and at 1, 3, 6, and 12\u2010months postimplantation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over a median 12\u2010month follow\u2010up, INTERMACS major bleeding events occurred in 35% of patients where TEG was utilized compared with 29% where TEG was not utilized (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.375), and procedural intervention was required in 29% compared with 18%, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.058). Use of TEG was associated with higher doses of aspirin (&gt;325\u2009mg) (41% compared with none) and use of a second antiplatelet (dipyridamole) (43% compared to 1%). Despite this, there was no significant difference in thromboembolic events (15% in each).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study suggests the use of TEG led to increased doses of aspirin as well as adding a second antiplatelet agent, without improving outcomes in LVAD recipients. Furthermore, the removal of TEG from an LVAD\u2010specific APT protocol did not worsen thromboembolic outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocs.16637","type":"journal-article","created":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T23:08:56Z","timestamp":1653433736000},"page":"2621-2628","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Fixed\u2010dose aspirin monotherapy compared with thromboelastography directed antiplatelet therapy in long\u2010term management of left ventricular assist devices"],"prefix":"10.1155","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5749-330X","authenticated-orcid":false,"given":"Sophia J.","family":"Fanelli","sequence":"first","affiliation":[{"name":"College of Medicine University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Elzeneini","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren E.","family":"Meece","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric I.","family":"Jeng","sequence":"additional","affiliation":[{"name":"Division of Thoracic and Cardiovascular Surgery University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Pathology, Immunology &amp; Laboratory Medicine University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2781-7873","authenticated-orcid":false,"given":"Mustafa M.","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2018.11.011"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1800866"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602954"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.03.010"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001138"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.035722"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.117.004628"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2014.11.008"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.019692"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.05.016"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000274"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivt546"},{"key":"e_1_2_9_14_1","unstructured":"Intermacs Appendices\u2014University of Alabama School of Medicine Interagency Registry for Mechanically Assisted Circulatory Support. 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