Comparison of Neurologic Event Rates Among HeartMate II, HeartMate 3, and HVAD

Strokes remain a leading cause of morbidity and mortality in patients with ventricular assist devices (VADs). Varying study populations, event definitions, and reporting methods make direct comparison of neurologic event risk across clinical trials and registries challenging. We aim to highlight important differences among major VAD studies and standardize rates of neurologic events to facilitate a comprehensive and objective comparison. We systematically identified and analyzed key clinical trials and registries evaluating the HeartMate II (HMII), HeartMate 3 (HM3), and HVAD devices. Reported neurologic events were nonexclusively categorized into ischemic stroke, hemorrhagic stroke, disabling stroke, fatal stroke, and other neurologic events per the studies’ definitions. Event rates were standardized to events per patient-year (EPPY) and freedom from event formats. Seven key clinical trials and registries were included in our analysis. There is significant variation and overlap in neurologic event rates for the three VAD platforms across clinical trials (all neurologic events [EPPY]: HM3 0.17–0.21; HMII 0.19–0.26; HVAD 0.16–0.28). None performs consistently better for all types of neurologic events. Furthermore, stroke rates among VAD trials correlated with baseline stroke risk factors including ischemic etiology, history of atrial fibrillation, and history of prior stroke.
Source: ASAIO Journal - Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

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Source: Revue Neurologique - Category: Neurology Tags: Rev Neurol (Paris) Source Type: research
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Source: Journal of Cancer - Category: Cancer & Oncology Authors: Tags: Research Paper Source Type: research
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Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Abstract Our objective was to assess the association between reduced apixaban dose and two outcomes: ischemic stroke/systemic embolism (SE) and major bleeding. We performed a retrospective cohort study within the database of the largest healthcare provider in Israel. We identified all patients diagnosed with atrial fibrillation, who started apixaban treatment between 2013 and 2017. Apixaban users were classified into three dosing regimen groups based on their renal function, age and weight: standard dose (5 mg bid), adjusted reduced dose (2.5 mg bid), and underdosing (2.5 mg bid). Patients were followed throu...
Source: Clinical Pharmacology and Therapeutics - Category: Drugs & Pharmacology Authors: Tags: Clin Pharmacol Ther Source Type: research
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Source: Drug Safety - Category: Drugs & Pharmacology Source Type: research
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Source: American Journal of Cardiovascular Drugs - Category: Cardiology Source Type: research
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Source: Journal of the National Medical Association - Category: General Medicine Tags: J Natl Med Assoc Source Type: research
Atrial fibrillation is the most common sustained cardiac arrhythmia in the general population. In western countries with aging populations, atrial fibrillation poses a significant health concern, as it is associated with a high risk of thromboembolism, stroke, congestive heart failure, and myocardial infarction. Thrombi are generated in the left atrial appendage, and subsequent embolism into the cerebral circulation is a major cause of ischemic stroke. Therefore, patients have a lifetime risk of stroke, and those at high risk, defined as a CHA2DS2-VASc2 (congestive heart failure, hypertension, age>75 years, diabetes mel...
Source: Cardiology in Review - Category: Cardiology Tags: Review Articles Source Type: research
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Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ARTICLES Source Type: research
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Source: Neurologia i Neurochirurgia Polska - Category: Neurology Authors: Tags: Neurol Neurochir Pol Source Type: research
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