AHA 23 - Investigator, Dr Mandeep R Mehra (Brigham and Women's Hospital and Harvard Medical School, US) is joined by Late-breaker host, Dr Harriette Van Spall (McMaster University, CA) to discuss the ARIES HM3 trial.

ARIES HM3 is a prospective, randomised, double-blinded, placebo-controlled clinical investigation into heart failure (HF) patients treated with the ARIES HeartMate 3 pump, who were treated with two different antithrombotic regimens. One treatment group received a Vitamin K antagonist, whereas another group received a vitamin K antagonist with placebo.

The non-inferiority endpoint for this study will be met if the placebo arm is non-inferior to the aspirin arm in the composite of survival free of any non-surgical major hemocompatibility-related adverse event at one-year post-implant.

Findings indicated that the omission of aspirin from an antithrombotic regimen including a VKA in advanced heart failure patients with a left ventricular assist device (LVAD) demonstrated non-inferiority when compared to a regimen that included aspirin. This approach was also associated with a reduction in bleeding events without an increased risk of thromboembolic events. Notably, the study observed a substantial 47% decrease in the number of hospitalization days, accompanied by a 41% reduction in the cost of managing bleeding events. Researchers estimated that for every 100 patients receiving the study LVAD, the strategy of avoiding aspirin therapy prevented approximately 14.5 major bleeding events during the first year.

Recorded Remotely from Boston, MA, 2023.