Primary Exchange of Heart Mate II Comes with Less Mortality/Treatment Failure within Six Months Than Eptifibatide Treatment

Purpose We compared those who got a VAD exchange primarily vs those who got eptifibatide treatment to establish which strategy was most beneficial in avoiding the primary endpoint of death or re-thrombosis Methods In a retrospective cohort study of patients with primary pump thrombosis (n=52), split into those that received an initial pump exchange (n=16) vs those who were treated with eptafibatide (n=36) a survival analysis was performed with the primary combined endpoint of death or new pump thrombosis at six months. The Kaplan-Meier curves created were tested for significant differences with a log-rank test. Univariate analysis of background parameters was performed between cohorts and relevant factors were built in a multiple logistic regression analysis to identify important predictors of the primary endpoint Results Although the Eptafibatide treatment was successful in 40% of the cases in avoiding death or the need for re-addressing pump-thrombosis a primary change of the pump was successful in about 80 % (p= 0.021) of the cases at six months. The frequency of major bleeds was also higher in the eptifibatide group (37.5% vs 52.8%; p=0.009) Conclusion Patients with a significant VAD thrombosis are better served with a primary pump exchange than eptifibatide treatment. We compared those who got a VAD exchange primarily vs those who got eptifibatide treatment to establish which strategy was most beneficial in avoiding the primary endpoint of death or re-thrombosis In a retrospective cohort study of patients with primary pump thrombosis (n=52), split into those that received an initial pump exchange (n=16) vs those who were treated with eptafibatide (n=36) a survival analysis was performed with the primary combined endpoint of death or new pump thrombosis at six months. The Kaplan-Meier curves created were tested for significant differences with a log-rank test. Univariate analysis of background parameters was performed between cohorts and relevant factors were built in a multiple logistic regression analysis to identify important predictors of the primary endpoint Although the Eptafibatide treatment was successful in 40% of the cases in avoiding death or the need for re-addressing pump-thrombosis a primary change of the pump was successful in about 80 % (p= 0.021) of the cases at six months. The frequency of major bleeds was also higher in the eptifibatide group (37.5% vs 52.8%; p=0.009) Patients with a significant VAD thrombosis are better served with a primary pump exchange than eptifibatide treatment.