Real-World Hemocompatibility Outcomes With Aspirin Omission in a Novel Fully Magnetically Levitated Left Ventricular Assist Device

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Evidence from the fully magnetically levitated HeartMate 3 has suggested that aspirin omission may be safe and potentially beneficial. CH-VAD, a novel fully magnetically levitated ventricular assist device, has historically used standard anticoagulation protocols. This multicenter, retrospective study aimed to assess the impact of aspirin omission on hemocompatibility-related adverse events (HRAE) in CH-VAD patients. Among 274 patients implanted with the CH-VAD across 13 centers in China, 220 met the inclusion criteria; 155 received aspirin plus warfarin, and 65 received warfarin alone. The primary endpoint was survival free from major nonsurgical HRAEs, defined as stroke, pump thrombosis, major bleeding, or peripheral arterial thromboembolism beyond 14 days postimplantation. During a median follow-up of 368 days (interquartile range [IQR], 173-597), 186 patients (84.5%) met the primary endpoint. Twelve month survival free from major nonsurgical HRAEs was 85.7% in patients treated with warfarin alone and 82.6% in those treated with warfarin and aspirin (log-rank p = 0.8771). Rates of thrombotic and hemorrhagic complications were not significantly different. In multivariable Cox modeling, baseline estimated glomerular filtration rate was the only independent predictor of HRAEs. In clinically stable CH-VAD recipients, warfarin monotherapy was not associated with a higher rate of HRAEs.