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Thromboembolic stroke in patients with a HeartMate-II left ventricular assist device - the role of anticoagulation.

Overview of attention for article published in Journal of Cardiothoracic Surgery, January 2015
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2 tweeters

Citations

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13 Dimensions

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Title
Thromboembolic stroke in patients with a HeartMate-II left ventricular assist device - the role of anticoagulation.
Published in
Journal of Cardiothoracic Surgery, January 2015
DOI 10.1186/s13019-015-0333-7
Pubmed ID
Authors

Walter M van den Bergh, Annemieke O Lansink-Hartgring, Abram L van Duijn, Annemarie E Engström, Jaap R Lahpor, Arjen JC Slooter, van den Bergh, Walter M, Lansink-Hartgring, Annemieke Oude, van Duijn, Abram L, Engström, Annemarie E, Lahpor, Jaap R, Slooter, Arjen Jc, Walter M. van den Bergh, Annemieke Oude Lansink-Hartgring, Abram L. van Duijn, Annemarie E. Engström, Jaap R. Lahpor

Abstract

It is unknown what the optimal anticoagulant level is to prevent thromboembolic stroke in patients with left ventricular assist device (LVAD) support. We aimed to evaluate the relation between coagulation status and the occurrence of thromboembolic stroke in HeartMate-II LVAD assisted patients. Thirty-eight consecutive patients with a HeartMate-II LVAD were included. Coagulation status was classified according to INR and aPTT ratio at: 1) the moment of first thromboembolic stroke; and 2) during the two weeks preceding the first thromboembolic stroke to assess long-term coagulation status. In patients without stroke, coagulation status was determined just before heart transplant, VAD explantation or death, whichever came first, and at two weeks preceding these surrogate endpoints. Based on coagulation status, patients were divided in two groups: Group I (reference group) was defined as INR below 2 and aPTT ratio below 1.5; Group II (adequate anticoagulation) as INR above 2 or aPTT ratio above 1.5. Logistic regression analysis was performed to assess the odds ratio for developing stroke for patients with adequate anticoagulation compared to the reference Group. Thromboembolic stroke occurred in six (16 %) patients, none within 2 weeks after LVAD implantation. Considering coagulation status at the time of event, patients in coagulation Group II had no decreased risk for thromboembolic stroke (OR 0.78; 95 % CI 0.12-5.0). Results for coagulation status 2 weeks prior of event could not be calculated as all six strokes occurred in Group II. In our experience anticoagulation within predefined targets is not associated with a reduced thromboembolic stroke risk in patients with a HeartMate-II LVAD on antiplatelet therapy. However, no firm statement about the effect of either anticoagulant or antiaggregant therapy can be made based on our study. A larger randomized study is needed to support the hypothesis that there may be no additional benefit of coumarin or heparin therapy compared with antiplatelet therapy alone.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 49 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
India 1 2%
Unknown 48 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 12 24%
Researcher 11 22%
Other 7 14%
Student > Doctoral Student 4 8%
Student > Bachelor 4 8%
Other 9 18%
Unknown 2 4%
Readers by discipline Count As %
Medicine and Dentistry 23 47%
Engineering 5 10%
Pharmacology, Toxicology and Pharmaceutical Science 3 6%
Agricultural and Biological Sciences 2 4%
Neuroscience 2 4%
Other 6 12%
Unknown 8 16%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 November 2015.
All research outputs
#9,664,993
of 15,922,193 outputs
Outputs from Journal of Cardiothoracic Surgery
#178
of 755 outputs
Outputs of similar age
#144,461
of 287,134 outputs
Outputs of similar age from Journal of Cardiothoracic Surgery
#18
of 46 outputs
Altmetric has tracked 15,922,193 research outputs across all sources so far. This one is in the 38th percentile – i.e., 38% of other outputs scored the same or lower than it.
So far Altmetric has tracked 755 research outputs from this source. They receive a mean Attention Score of 2.2. This one has done well, scoring higher than 75% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 287,134 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 48th percentile – i.e., 48% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 46 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 60% of its contemporaries.