251. Impact of ABO Blood Group on Thromboembolic and Bleeding Complications in Patients with Left Ventricular Assist Devices.
- Author
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Tscharre M, Wittmann F, Kitzmantl D, Schlöglhofer T, Cichra P, Lee S, Eichelberger B, Wadowski PP, Laufer G, Wiedemann D, Panzer S, Zimpfer D, and Gremmel T
- Subjects
- Humans, von Willebrand Factor metabolism, ABO Blood-Group System, P-Selectin, Factor VIII analysis, Hemorrhage etiology, Heart-Assist Devices adverse effects, Thromboembolism complications, Hemostatics, von Willebrand Diseases complications
- Abstract
Background: The ABO blood group system is linked to hemostasis via its relationship with von Willebrand factor (VWF) and factor VIII (FVIII). In the current study, we investigated the association of the ABO system with clinical outcomes as well as VWF and platelet function in patients with left ventricular assist devices (LVADs)., Methods: Bleeding and thromboembolic complications were assessed in 111 patients during 1 year after LVAD implantation. In 67 LVAD patients, VWF antigen, VWF activity, VWF ristocetin cofactor, VWF collagen-binding, and FVIII activity were assessed. Platelet surface P-selectin and activated glycoprotein IIb/IIIa were determined by flow cytometry, and soluble P-selectin was measured with an enzyme-linked immunoassay. Platelet aggregation was assessed by light transmission and impedance aggregometry., Results: Thirty-six patients (32.4%) experienced a bleeding and 22 patients (19.8%) a thromboembolic event. In univariate analyses, patients with blood group O had numerically more bleeding complications and less thromboembolic events as compared to patients with blood group non-O (both p ≥ 0.05). After multivariable adjustment, blood group O was significantly associated with a higher risk of bleeding (hazard ratio 2.42 [95% confidence interval 1.03-5.70], p = 0.044) but not linked to thromboembolic complications., Conclusion: Patients with blood group O had significantly lower levels of VWF and FVIII (all p < 0.05), whereas P-selectin expression in response to thrombin-receptor activating peptide and soluble P-selectin were higher as compared to patients with blood group non-O (both p < 0.05). LVAD patients with blood group O are at an increased bleeding risk, potentially due to lower VWF and FVIII levels., Competing Interests: T.S. received research grants from Abbott, CorWave, and Medtronic, and is a consultant for Abbott and Medtronic. D.W. is a consultant and proctor for Abbott and Medtronic. D.Z. received research grants from Abbott and Medtronic, is an advisory board member for Abbott, Medtronic, and Berlin Heart, and is a proctor for Abbott and Medtronic. T.G. received research grants from Boehringer-Ingelheim, Bristol Myers Squibb, Medtronic, and Abbott, and lecture fees from Amgen, Boehringer-Ingelheim, Bayer, Bristol Myers Squibb, Vifor, Daiichi Sankyo, Pfizer, and Novartis. The other authors have no relevant conflicts of interest to declare., (Thieme. All rights reserved.)
- Published
- 2023
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