Patients Living with a Heart Pump Benefit from Aspirin-Free Regimen

New research conducted at Columbia University Irving Medical Center and other locations shows that aspirin-free treatment can improve outcomes for people living with a heart pump by reducing hospitalizations without increasing the risk of blood clots. The study was presented during a late-breaking session at the 2023 American Heart Association Scientific Sessions in Philadelphia on Nov. 11 and simultaneously published in the Journal of the American Medical Association.

The ARIES-HM3 Randomized Clinical Trial

Typically, patients living with a heart pump called a left ventricular assist device (LVAD) are treated with a blood-thinning regimen, including aspirin, to prevent blood clots. But the use of aspirin is controversial and may contribute to serious bleeding events. Even as improvements in LVAD design have reduced other complications, bleeding remains one of the leading causes of rehospitalization among LVAD patients.

The multi-center ARIES-HM3 study, co-authored by Nir Uriel, MD, professor of medicine at Columbia University Vagelos College of Physicians and Surgeons and director of advanced heart failure and cardiac transplantation at NewYork-Presbyterian, sought to determine whether excluding aspirin among patients living with a HeartMate 3 LVAD is safe and decreases bleeding.

The study found that patients who didn’t receive aspirin spent 47% fewer days in the hospital due to a nearly 40% decrease in bleeding events compared to patients who continued to take aspirin daily.

“These findings can transform how physicians manage the care of these patients and significantly reduce hospitalizations,” says Uriel, who was also a member of the study’s steering committee and provided trial oversight.