NYMC Faculty Publications
Primary and Secondary Prevention Strategies for Gastrointestinal Bleeding in Patients with Left Ventricular Assist Device: A Systematic Review and Network Meta-analysis
Author Type(s)
Faculty
Journal Title
Current Problems in Cardiology
First Page
100835
Last Page
100835
Document Type
Review Article
Publication Date
11-2021
Department
Medicine
Abstract
Recurrent gastrointestinal bleeding (GIB) is a common complication following left ventricular assist device (LVAD) implantation. Our study aimed to estimate the comparative efficacy of different pharmacologic interventions for the prevention of GIB, through a network meta-analysis (NMA). A total of 13 observational studies comparing six strategies. Among those, 4 were for primary, and 9 were for secondary prevention of GIB. On NMA, thalidomide (Hazard ratio [HR]: 0.016, Credible interval [CrI]I: 0.00053-0.12), omega-3-fatty acid (HR:0.088, CrI: 0.026-0.77), octreotide (HR: 0.17, CrI: 0.0589-0.41) and danazol (HR:0.17, CrI: 0.059-0.41) reduced the risk of GIB. The use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blocker (ACEi/ARB) and digoxin were not associated with any significant reduction. Based on NMA, combining indirect treatment comparisons, thalidomide, danazol, and octreotide treatments were associated with decreased risk of recurrent GIB. Additionally, Omega 3 fatty acids were associated with a lower risk of the primary episode of GIB in the LVAD patient population.
Recommended Citation
Rai, D., Tariq, R., Tahir, M., Chowdhury, M., Wahab, A., Kharsa, A., Bandyopadhyay, D., Feitell, S. C., Parikh, V., Aronow, W. S., Lanier, G. M., Levine, E., Fonarow, G. C., & Kaul, V. (2021). Primary and Secondary Prevention Strategies for Gastrointestinal Bleeding in Patients with Left Ventricular Assist Device: A Systematic Review and Network Meta-analysis. Current Problems in Cardiology, 46 (11), 100835-100835. https://doi.org/10.1016/j.cpcardiol.2021.100835
