Association of Angiopoetin-2 and TNF-a With Bleeding During Left Ventricular Assist Device Support: Analysis from the PREVENT Biorepository. Journal Article

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Authors: Kim, G; Sayer, G; Ransom, J; Keebler, M; Katz, J; Kilic, A; Lindenfeld, J; Egnaczyk, G; Shah, P; Brieke, A; Walenga, J; Crandall, D; Farrar, DJ; Sundareswaran, K; Uriel, N
Article Title: Association of Angiopoetin-2 and TNF-a With Bleeding During Left Ventricular Assist Device Support: Analysis from the PREVENT Biorepository.
Abstract: The purpose of this study was to describe the changes in plasma levels of angiogenic and inflammatory biomarkers, specifically Ang-2 and TNF-a, in patients receiving HeartMate II (HMII) left ventricular assist device (LVAD) and correlate them with nonsurgical bleeding. It has been shown that angiopoietin-2 (Ang-2) and tissue necrosis factor-a (TNF-a) may be linked to bleeding in LVAD patients. This study utilized biobanked samples prospectively collected from the PREVENT study, a prospective, multicenter, single-arm, nonrandomized study of patients implanted with HMII. Paired serum samples were obtained in 140 patients before implantation and at 90 days postimplantation. Baseline demographics were as follows: age 57?±?13 years, 41% had ischemic etiology, 82% male, and 75% destination therapy indication. In the 17 patients with baseline elevation of both TNF-a and Ang-2, 10 (60%) experienced a significant bleeding event within 180 days postimplant compared with 37 of 98 (38%) patients with Ang-2 and TNF-a below the mean (p = 0.02). The hazard ratio for a bleeding event was 2.3 (95% CI: 1.2-4.6) in patients with elevated levels of both TNF-a and Ang-2. In the PREVENT multicenter study, patients with elevations in serum Angiopoietin-2 and TNF-a at baseline before LVAD implantation demonstrated increased bleeding events after LVAD implantation.
Journal Title: ASAIO Journal (American Society for Artificial Internal Organs : 1992)
ISSN: 1538-943X; 1058-2916
Publisher: Unknown  
Date Published: 2023