Omega-3 Therapy is Not Associated with Reduced Gastrointestinal Bleeding in HeartMate 3 Left Ventricular Assist Device Patients

Abstract

<h3>Purpose</h3> Previous studies showed that prophylactic administration of omega-3 was associated with increased freedom from gastrointestinal bleeding (GIB) in a cohort of patients receiving Heartmate II and HVAD devices. This study aims to assess whether reduction in GIB incidence can be achieved with omega-3 therapy in patients implanted with the newer Heartmate III LVAD. <h3>Methods</h3> We retrospectively analyzed 75 patients implanted with a Heartmate III LVAD at a large tertiary academic medical center between August 2013 and March 2020. 23 patients (56.2 ± 13.4 years old and 69.6% male) received omega-3 therapy at 2.4 ± 1.2 g/day, while 52 patients in the control group (55.0 ± 13.0 years old and 69.2% male) did not receive any omega-3 therapy. <h3>Results</h3> Incidence of GIB at 1 year was not significantly different in the omega-3 group as compared with the control group (25.0% versus 30.4%, P=0.836). Omega-3 therapy was not associated with the occurrence of GIB at 1 year (HR, 1.375; 95% CI, 0.520-3.636; P=0.520). No significant difference was observed when patients were further stratified into dosage groups of those receiving 1, 2, or 4 g/day of omega-3. <h3>Conclusion</h3> In this single center retrospective study, omega-3 therapy was not associated with a lower rate of GIB in patients implanted with the newer Heartmate III LVAD consistent with previously reported findings that this cohort of patients experiences fewer hemocompatibility related adverse events overall at baseline. Future studies are warranted to better understand whether innate technological advances of Heartmate III operate through the same mechanisms as omega-3 therapy to confer similar but non-additive effects on the incidence of GIB.