Schnegg, Bruno; Deveza, Ricardo; Hayward, Christopher (2024). Apixaban in bridge to transplant and destination LVAD - rationale and study design: the ApixiVAD trial. (In Press). ESC heart failure 10.1002/ehf2.14782
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ESC_Heart_Failure_-_2024_-_Schnegg_-_Apixaban_in_bridge_to_transplant_and_destination_LVAD___rationale_and_study_design_.pdf - Published Version Available under License Creative Commons: Attribution-Noncommercial (CC-BY-NC). Download (429kB) | Preview |
AIMS
Use of novel anticoagulation in mechanical circulatory support is controversial. We report the rationale and design of the ApixiVad pilot trial, a pilot study testing the safety of apixaban as an anticoagulant in patients bridged to transplant (BTT) or for destination (DT) with Heartmate 3 (HM3) left ventricular assist device (LVAD).
METHODS AND RESULTS
Apixaban has been used in small non-randomized cohorts in LVAD patients and shown to be effective in ex vivo studies. The ApixiVAD study examines apixaban use in a multicentre, international, open-label, randomized, controlled trial aiming to include 50 BTT or DT HM3 patients with a 1:1 randomization ratio. This event-driven study has a maximum follow-up period of 24 months with interim analysis at 6 months. The primary outcome is death, thromboembolic events and major bleeding, including operative bleeding and immediate transplant outcomes. The secondary outcome focuses on patients' quality of life related to anticoagulation. This investigator-driven pilot study is not powered to determine the non-inferiority of apixaban. An increase in primary outcome in the apixaban group of 20% will be considered a signal of harm.
CONCLUSIONS
A positive outcome in the ApixiVAD study would provide the basis for future, larger, pivotal anticoagulation trials in LVAD patients.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Schnegg, Bruno |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2055-5822 |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
24 Apr 2024 16:06 |
Last Modified: |
24 Apr 2024 19:43 |
Publisher DOI: |
10.1002/ehf2.14782 |
PubMed ID: |
38650125 |
Uncontrolled Keywords: |
DOAC HeartMate 3 LVAD apixaban |
BORIS DOI: |
10.48350/196189 |
URI: |
https://boris.unibe.ch/id/eprint/196189 |
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