Abstract 19132: Home Monitoring is Associated With Fewer Gastrointestinal Bleeding Events Following Left Ventricular Assist Device Implantation

Introduction: Patients (pts) treated with a continuous flow left ventricular assist device (LVAD) are at increased risk for both bleeding and thromboembolic events. Maintenance of oral anticoagulation (AC) in the therapeutic range is difficult to achieve. Hypothesis: Increased frequency of international normalized ratio (INR) home monitoring (HM) decreases the incidence of gastrointestinal bleeding and thromboembolic events (stroke, pump thrombosis) compared to standard of care (SOC). Methods: We analyzed the efficacy of outpatient AC monitoring in consecutive pts who underwent LVAD implantation at our institution between 2011-2016. Time in therapeutic range (TTR) was defined as percent of time with INR 2.0-2.5. HM pts had biweekly INR measurements using the Alere monitor (Waltham, MA), while SOC pts had INR measured every 1-3 weeks. Gastrointestinal bleeding (GIB) and thromboembolic events (THROMB) were assessed by retrospective blinded chart review. Logistic regression was used to model the impact of TT...