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Continuous flow ventricular assist devices do not worsen GI bleeding risk

03 Sep 2020

The use of continuous flow ventricular assist devices (VADs), regardless of the type, does not appear to exacerbate the risk of gastrointestinal bleeding (GIB), according to a recent meta-analysis.

Researchers retrieved five studies from online databases, selecting only randomized controlled trials and observational studies. The cumulative sample eligible for quantitative analysis consisted of 1,853 participants who received either centrifugal flow (CF) or axial flow (AF) VADs. Overall quality was adequate, with a minimum score of seven out of a total nine stars in the Newcastle-Ottawa Scale.

The occurrence of GIB was comparable between the two device types, although statistical significance was nearly achieved (odds ratio [OR], 0.81, 95 percent confidence interval [CI], 0.65–1.00; p=0.05) in favour of CF-VAD.

This borderline-significance was driven by one study, which found that the AF devices triggered more GIB events than the CF comparators (OR, 0.74, 95 percent CI, 0.56–0.97; p=0.03).

The between-study variance in the meta-analysis was 0±0.06, and the variation in the estimated effect sizes was lower than expected. Egger’s regression test was not significant. Nevertheless, the researchers said that the small number of studies included could have weakened the statistical power of the tests in the meta-analysis.

“Regardless of the type of continuous flow VAD used, GIB continues to be a major challenge in these patients. We recommend that more research should be conducted on this topic to aid the feasibility of a broader meta-analysis,” researchers said. “Data on outcomes should be explicitly outlined and possible confounding factors should be controlled.”

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Most Read Articles
3 days ago
Chest pain appears to be the principal complaint of patients hospitalized with a first myocardial infarction (MI), particularly among those in the youngest age group, a study has found.
Jairia Dela Cruz, 16 Sep 2020
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.
Pearl Toh, 3 days ago
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
4 days ago
Women with pre-eclampsia are at higher risk of developing heart failure, a study suggests.