{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T06:44:29Z","timestamp":1787294669567,"version":"build-2736575974"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Left ventricular assist devices (LVADs) have emerged as an effective treatment for patients with advanced heart failure refractory to medical therapy. Post-LVAD strokes are an important cause of morbidity and reduced quality of life. Data on risks that distinguish between ischemic and hemorrhagic post-LVAD strokes are limited. The aim of this study was to determine the incidence of post-LVAD ischemic and hemorrhagic strokes, their association with stroke risk factors, and their effect on mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>Data are collected prospectively on all patients with LVADs implanted at Brigham and Women\u2019s Hospital. We added retrospectively collected clinical data for these analyses.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>From 2007 to 2016, 183 patients (median age, 57; 80% male) underwent implantation of HeartMate II LVAD as a bridge to transplant (52%), destination therapy (39%), or bridge to transplant candidacy (8%). A total of 48 strokes occurred in 39 patients (21%): 28 acute ischemic strokes in 24 patients (13%) and 20 intracerebral hemorrhages in 19 patients (10.3%). First events occurred at a median of 238 days from implantation (interquartile range, 93\u2013515) among those who developed post-LVAD stroke. All but 9 patients (4.9%) were on warfarin (goal international normalized ratio, 2\u20133.5) and all received aspirin (81\u2013325 mg). Patients with chronic obstructive pulmonary disease were more likely to have an ischemic stroke (odds ratio, 2.96; 95% confidence interval, 1.14\u20137.70). Dialysis-dependent patients showed a trend toward a higher risk of hemorrhagic stroke (odds ratio, 6.31; 95% confidence interval, 0.99\u201340.47). Hemorrhagic stroke was associated with higher mortality (odds ratio, 3.92; 95% confidence interval, 1.34\u201311.45) than ischemic stroke (odds ratio, 3.17; 95% confidence interval, 1.13\u20138.85).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Stroke is a major cause of morbidity and mortality in patients on LVAD support. Chronic obstructive pulmonary disease increases the risk of ischemic stroke, whereas dialysis may increase the risk of hemorrhagic stroke. Although any stroke increases mortality, post-LVAD hemorrhagic stroke was associated with higher mortality compared with ischemic stroke.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.117.020002","type":"journal-article","created":{"date-parts":[[2018,4,11]],"date-time":"2018-04-11T09:05:41Z","timestamp":1523437541000},"page":"1197-1203","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["Cerebrovascular Accidents During Mechanical Circulatory Support"],"prefix":"10.1161","volume":"49","author":[{"given":"Saef","family":"Izzy","sequence":"first","affiliation":[{"name":"From the Department of Neurology, Brigham and Women\u2019s Hospital, Boston, MA (S.I., D.B.R., F.A., H.V., S.K.F.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel B.","family":"Rubin","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Brigham and Women\u2019s Hospital, Boston, MA (S.I., D.B.R., F.A., H.V., S.K.F.)"},{"name":"Department of Neurology, Massachusetts General Hospital, Boston (D.B.R., F.A.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firas S.","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Radiology, Columbia University Medical Center, New York, NY (F.S.A.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feras","family":"Akbik","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Brigham and Women\u2019s Hospital, Boston, MA (S.I., D.B.R., F.A., H.V., S.K.F.)"},{"name":"Department of Neurology, Massachusetts General Hospital, Boston (D.B.R., F.A.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Renault","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine, Los Angeles, CA (S.R.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katelyn W.","family":"Sylvester","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, Brigham and Women\u2019s Hospital, Boston, MA (K.W.S.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrikas","family":"Vaitkevicius","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Brigham and Women\u2019s Hospital, Boston, MA (S.I., D.B.R., F.A., H.V., S.K.F.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A.","family":"Smallwood","sequence":"additional","affiliation":[{"name":"Department of Preventative Medicine &amp; Epidemiology, Boston University School of Medicine, MA (J.A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"Givertz","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.G.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven K.","family":"Feske","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Brigham and Women\u2019s Hospital, Boston, MA (S.I., D.B.R., F.A., H.V., S.K.F.)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067758"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2014.11.007"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909938"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2017.07.005"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa053063"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001573-200403000-00015"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2008.10.011"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8191.2012.01504.x"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-10-0986"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2017.06.014"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2016.12.010"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2016.03.014"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.08.1656"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-017-0386-7"},{"key":"e_1_3_2_16_2","first-page":"245","article-title":"Low incidence of neurologic events during long-term support with the HeartMate XVE left ventricular assist device.","volume":"35","author":"Slaughter MS","year":"2008","unstructured":"Slaughter MS, Sobieski MA, Gallagher C, Dia M, Silver MA. 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