Doxycycline may cut bleeding with ventricular assist device

(HealthDay)—Doxycycline can potentially cut left ventricular assist device (LVAD)-associated bleeding, according to a study published online Oct. 7 in JACC: Heart Failure.

Carlo R. Bartoli, M.D., Ph.D., from the University of Pennsylvania in Philadelphia, and colleagues used whole blood samples from 15 donors to quantify the dose relationship between doxycycline and plasma ADAMTS-13 activity before shear stress (n=10). Plasma was exposed to LVAD-like supraphysiologic shear stress (~175 dyne/cm²).

The researchers found that doxycycline significantly decreased ADAMTS-13 activity and the activity of recombinant ADAMTS-13 by 21 percent. The same pattern of vWF degradation as previously reported for LVAD patients was observed, and vWF:collagen binding activity decreased significantly after plasma was exposed to shear stress. VWF:collagen binding activity was significantly restored as a result of doxycycline significantly decreasing ADAMTS-13 activity and the activity of recombinant ADAMTS-13 by 18 percent, protecting large vWF multimers from degradation, and significantly decreasing the five smallest vWF fragments.

"ADAMTS-13 is a clinical target to reduce vWF degradation, improve vWF function, and potentially reduce bleeding during LVAD support," the authors write.