PHILADELPHIA, Pennsylvania — Aspirin may not be necessary or beneficial in patients with advanced heart failure who get a left ventricular assist device (LVAD), particularly if it's a newer device that does not use the centrifugal- or continuous-flow pump technology of conventional LVADs, new randomized results suggest.
"We've always thought that somehow aspirin prevents stroke and prevents clotting and that it's anti-inflammatory, and what we found in ARIES was the exact opposite," said Mandeep Mehra, MD, of Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School in Boston, Massachusetts, who reported results of the ARIES-HM3 trial of the HeartMate 3 LVAD, a device that uses a fully magnetically levitated rotor to maintain blood flow.
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ARIES-HM3 randomly assigned 589 patients who received the HeartMate 3 device to vitamin K therapy with aspirin or to placebo. Mehra said it was the first international trial to conclusively evaluate medical therapy in patients who get an LVAD.
Unexpected Findings
"To be honest with you, we set this up as a safety study to see if we could eliminate aspirin," Mehra said in an interview. "We didn't expect that the bleeding rates would decrease by 34% and that gastrointestinal (GI) bleeding in particular would decrease by 40%.
