Hemocompatibility related complications in Impella 5+ patients treated with Bivalirudin and dual antiplatelet therapy: a SHEAR score evaluation

BACKGROUND: The surgical Impella 5.0 and 5.5 (5+) provide greater and more durable hemodynamic support than Impella CP in patients with cardiogenic shock. The concomitant need for DAPT on top of systemic anticoagulation might increase the risk for hemocompatibility-related adverse events. METHODS: 13 patients who underwent primary PCI and Impella 5+ support and were treated with DAPT and Bivalirudin. We evaluated adverse events (AEs) and hemocompatibility-related complications according to the SHEAR score. RESULTS: Median duration of Impella 5+ support was 14 ± 32 days. At baseline, all patients had risk for bleeding because of DAPT (SHEAR A); moreover, 2 patients suffered from thrombocytopenia. None presented risk factors for thrombosis. The highest total SHEAR score was 6 in 2 patients, three patients had a total SHEAR score of 3, three patients had a total SHEAR score of 2, 5 patients had a total SHEAR score of 1. Both bleeding and thrombotic events were most frequent within the first 48 h of support, and bleeding events had a greater role in determining the hemocompatibilty score. No patient suffered from clinically relevant hemocompatibility-related adverse events. CONCLUSIONS: In conclusion, we report a low rate of thrombotic and hemorrhagic events in a cohort of AMI-CS patients requiring Impella 5+ support and treated with bivalirudin and DAPT, according to the SHEAR score classification. This is further confirmed by the ability of the SHEAR score to add multiple events that can occur during prolonged support. Further studies are urgently needed to confirm this new approach in tMCS.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Cohort study of 13 cardiogenic-shock patients on Impella 5+ MCS with dual antiplatelet therapy and bivalirudin, evaluating hemocompatibility events using the SHEAR score. No clinically significant hemocompatibility-related adverse events occurred.

Leech-derived molecules this paper discusses, each with a full profile in the ASH compound registry:

Узнайте, как это исследование связано с клинической практикой

More peer-reviewed studies in Разработка лекарственных препаратов.

• Novel Leech Antimicrobial Peptides — Hirunipins — Kumar et al. (2025)
• Medicinal Leech Genome Assembly — Anticoagulant Gene Catalog — Kvist et al. (2020)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• Hirudotherapy in Medicine and Dentistry — Jha K et al. (2015)
• Medicinal leech therapy (hirudotherapy): a brief overview — Singh A (2010)
• HIRUDOTHERAPY IN PRESBYACUZIS PRAECOX IN CLEAN-UP WORKERS AFTER THE CHORNOBYL ACCIDENT DURING THE POST-CATASTROPHE YEARS — Zabolotnyi D, Mishchanchuk N (2019)
• Investigation of oxidant-antioxidant status in patients treated with hirudotherapy: an experimental study — Sarikan I, Savas H (2024)
• Leech therapeutic applications — Abdualkader A et al. (2013)
• Non-Occlusive Mesenteric Ischemia Due to Hirudotherapy: A Case Report — Akalın Ç, Ekmen N (2020)
• Leech therapy: a history — Hyson J (2005)

Browse all ASH-analysed research →