Apixaban Anticoagulation in HeartMate 3 Left Ventricular Assist Device
Résumé
Although Vitamin-K antagonists (VKAs) are the gold-standard for anticoagulation in patients with left ventricular assist device (LVAD), apixaban has been suggested as a bleedingreducing alternative, but its use remains controversial. We performed a meta-analysis of randomised controlled trials (RCTs) assessing safety of apixaban in LVAD patients compared with VKAs. Seventy-five patients were randomized to apixaban (n = 47) or warfarin (n = 28).
Survival-free from hemocompatibility-related adverse events was similar between groups (RR 0.90 [0.77 -1.05], p = 0.55). No patients experienced thromboembolic complications.
Apixaban appears feasible in selected LVAD patients and large-scale RCTs are warranted to clarify its use.