{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390001205107537024.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.1253/circj.cj-17-0897"}},{"identifier":{"@type":"PMID","@value":"29237991"}},{"identifier":{"@type":"DOI","@value":"10.1253/circj.cj-18-0329"}},{"identifier":{"@type":"PMID","@value":"29618698"}},{"identifier":{"@type":"NDL_BIB_ID","@value":"028956874"}},{"identifier":{"@type":"URI","@value":"http://id.ndl.go.jp/bib/028956874"}},{"identifier":{"@type":"URI","@value":"https://ndlsearch.ndl.go.jp/books/R000000004-I028956874"}},{"identifier":{"@type":"URI","@value":"https://www.jstage.jst.go.jp/article/circj/82/5/82_CJ-18-0329/_pdf"}},{"identifier":{"@type":"URI","@value":"https://www.jstage.jst.go.jp/article/circj/82/5/82_CJ-17-0897/_pdf"}},{"identifier":{"@type":"NAID","@value":"130006726015"}},{"identifier":{"@type":"NAID","@value":"130006725965"}}],"resourceType":"エディトリアル(editorial)","dc:title":[{"@language":"en","@value":"Survival of HeartMate II Patients Despite  Cessation of Anticoagulation　― Outcomes and Hemostatic Analysis ―"},{"@value":"Anticoagulation Therapy After Left Ventricular Assist Device Implantation"}],"dc:language":"en","description":[{"type":"abstract","notation":[{"@language":"en","@value":"<p><b><i>Background:</i></b>In long-term left ventricular assist device (LVAD) therapy, recurrent bleeding events may justify cessation of anticoagulation therapy (AT). However, data about THE safety and risks of AT cessation in LVAD patients are scarce.</p><p><b><i>Methods and Results:</i></b>Between 2010 and 2015, 128 patients received a HeartMate II (HMII). Following recurrent bleeding events, we ceased vitamin K antagonist (VKA) therapy in 13 patients (10%) (no-VKA group). To characterize the hemostatic profile, we performed von Willebrand factor (vWF), platelet function (PF), and other hemostatic tests in all HMII patients. The incidence of pump thrombosis (PT), ischemic stroke (IS) and bleeding events in this HMII population was 4.7 %, 6.2% and 36.7%, respectively. Median survival without VKA was 435 days. No cases of PT and only 1 of IS occurred after AT discontinuation. All patients had impaired PF and acquired von Willebrand syndrome (AvWS). However, the vWF collagen-binding activity to antigen ratio before and after VKA cessation was significantly lower in the no-VKA group compared with the HMII population (0.60±0.12 vs. 0.73±0.14, P=0.006). The thrombin-antithrombin III complex (TAT) value was significantly higher in the no-VKA group (P=0.0005).</p><p><b><i>Conclusions:</i></b>We experienced good results with AT cessation in specific HMII patients. The simultaneous onset of AvWS and high TAT values could explain at least in part the low thromboembolic rate in HMII patients without VKA.</p>"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410001205107537030","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000389434935"}],"foaf:name":[{"@language":"en","@value":"Grottke Oliver"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Anesthesiology, RWTH University Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001205107537024","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000389434934"}],"foaf:name":[{"@language":"en","@value":"Khattab Mohammad Amen"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001205107537031","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000389434937"}],"foaf:name":[{"@language":"en","@value":"Goetzenich Andreas"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001205107537028","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000389434938"}],"foaf:name":[{"@language":"en","@value":"Moza Ajay"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001205107537032","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000389434936"}],"foaf:name":[{"@language":"en","@value":"Honickel Markus"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Anesthesiology, RWTH University Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001205107537026","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000389434939"}],"foaf:name":[{"@language":"en","@value":"Stoppe Christian"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Intensive Care Medicine, RWTH University Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001205107537029","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000389434941"}],"foaf:name":[{"@language":"en","@value":"Tewarie Lachmandath"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001205107537027","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000389434940"}],"foaf:name":[{"@language":"en","@value":"Autschbach Rüdiger"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001205107537025","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000389434933"}],"foaf:name":[{"@language":"en","@value":"Zayat Rashad"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"13469843"},{"@type":"LISSN","@value":"13469843"},{"@type":"EISSN","@value":"13474820"},{"@type":"NDL_BIB_ID","@value":"000000402515"},{"@type":"ISSN","@value":"13469843"},{"@type":"NCID","@value":"AA11591968"}],"prism:publicationName":[{"@language":"en","@value":"Circulation Journal"},{"@language":"en","@value":"Circ J"}],"dc:publisher":[{"@language":"en","@value":"The Japanese Circulation Society"},{"@language":"ja","@value":"一般社団法人 日本循環器学会"}],"prism:publicationDate":"2018","prism:volume":"82","prism:number":"5","prism:startingPage":"1309","prism:endingPage":"1318"},"reviewed":"false","dcterms:accessRights":"http://purl.org/coar/access_right/c_abf2","url":[{"@id":"http://id.ndl.go.jp/bib/028956874"},{"@id":"https://ndlsearch.ndl.go.jp/books/R000000004-I028956874"},{"@id":"https://www.jstage.jst.go.jp/article/circj/82/5/82_CJ-18-0329/_pdf"},{"@id":"https://www.jstage.jst.go.jp/article/circj/82/5/82_CJ-17-0897/_pdf"}],"availableAt":"2018","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=Anticoagulation","dc:title":"Anticoagulation"},{"@id":"https://cir.nii.ac.jp/all?q=Bleeding","dc:title":"Bleeding"},{"@id":"https://cir.nii.ac.jp/all?q=HeartMate%20II","dc:title":"HeartMate II"},{"@id":"https://cir.nii.ac.jp/all?q=Left%20ventricular%20assist%20device","dc:title":"Left ventricular assist device"},{"@id":"https://cir.nii.ac.jp/all?q=Pump%20thrombosis","dc:title":"Pump thrombosis"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360292619680329216","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Unexpected Abrupt Increase in Left Ventricular Assist Device Thrombosis"}]},{"@id":"https://cir.nii.ac.jp/crid/1360292620546120704","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Adverse events in contemporary continuous-flow left ventricular assist devices: A multi-institutional comparison shows significant differences"}]},{"@id":"https://cir.nii.ac.jp/crid/1360292620664824448","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Pump thrombosis in the Thoratec HeartMate II device: An update analysis of the INTERMACS Registry"}]},{"@id":"https://cir.nii.ac.jp/crid/1360574094069259392","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Surgical Technique Influences HeartMate II Left Ventricular Assist Device 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