Bleeding Reduction in LVAD Patients with Aspirin Discontinuation: ARIES-HM3 Trial

Aspirin may not be necessary or beneficial in patients with advanced heart failure who get a left ventricular assist device (LVAD), 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. ARIES-HM3 randomly assigned 589 patients who received the HeartMate 3 device to vitamin K therapy with aspirin or to placebo. Result: The bleeding rates would decrease by 34% and that gastrointestinal (GI) bleeding in particular would decrease by 40%. We didn't expect that it would nearly halve the days spent in the hospital, and we didn't expect that the cost of care would decrease by 40%." The researchers found that 74% of patients in the placebo group met the primary endpoint of being alive and not having any hemocompatibility events at 12 months vs 68% of the aspirin patients. The rate of nonsurgical bleeding events was 30% in the placebo group vs 42.4% in the aspirin patients. The rates of GI bleeding were 13% and 21.6% in the respective groups. The placebo group spent 47% fewer days in the hospital for bleeding, with hospitalization costs 41% lower than the aspirin group. Disclaimer: Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any scientific information shared by the HCP on the ­­­STAR UPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.