Left ventricular assist device-induced coagulation and platelet activation and effect of the current anticoagulant therapy regimen Journal Article


Authors: Ashbrook, M.; Walenga, J. M.; Schwartz, J; Heroux, A.; Jeske, W. P.; Escalante, V; Bakhos, M.
Article Title: Left ventricular assist device-induced coagulation and platelet activation and effect of the current anticoagulant therapy regimen
Abstract: Left ventricular assist devices (LVADs) are mechanical pumps that enhance cardiac function in patients with heart failure. In all, 7 patients with an LVADs (1.8 international normalized ratio warfarin, 81 mg aspirin) were evaluated monthly for 3 months for platelet and coagulation activation (controls: 5 healthy adults and 5 patients having warfarin). Platelet works revealed greater inhibition of collagen (31.8% vs 7.9%; P = .004), arachidonate- (30.9% vs 8.2%; P = .001), and adenosine diphosphate- (10.9% vs 6.1%; P = .004)-induced platelet aggregation for LVADs. Thrombelastography (recalcified whole blood) showed inhibition of clot initiation time (R; 8.81 vs 6.02 min; P = .001) and stronger clot formation (maximum amplitude; 69.1 vs 64.9 mm; P = .016). Platelet function determined by plateletMapping and flow cytometry was within the normal range. The LVADs had increased ratio of von Willebrand Factor (vWF) antigen and vWF propeptide, indicating increased degradation of vWF (2.04 vs 1.44; P = .144). Coagulation and platelet activation caused by LVAD is suppressed by pharmacotherapy, yielding a profile similar to that of patients on warfarin alone.
Keywords: coagulation; heart failure; platelets; ventricular assist device; Thoracic and Cardiovascular Surgery
Journal Title: Clinical Applied Thrombosis/Hemostasis
Volume: 19
Issue: 3
ISSN: 1938-2723
Publisher: Unknown  
Journal Place: United States
Date Published: 2013
Start Page: 249
End Page: 255
Language: eng
DOI/URL:
Notes: JID: 9508125; OTO: NOTNLM; 2012/11/15 [aheadofprint]; ppublish