Transcatheter Aortic Valve Implantation (TAVI) is increasingly being performed in
patients with severe aortic stenosis.
1
The current American guidelines recommend dual antiplatelet therapy (DAPT) for the
first 3 to 6 months after TAVI in patients who are not on anticoagulation.
1
These recommendations have been established based on experts’ opinions due to the
lack of clinical trials investigating the optimal antithrombotic therapy in this population.
More recently, multiple studies have questioned the benefit of DAPT in reducing thromboembolic
outcomes and revealed high bleeding events in patients who received DAPT after TAVI
compared with aspirin monotherapy.
2
,
- Brouwer J
- Nijenhuis VJ
- Delewi R
- Hermanides RS
- Holvoet W
- Dubois CLF
- Frambach P
- De Bruyne B
- van Houwelingen GK
- Van Der Heyden JAS
- Toušek P
- van der Kley F
- Buysschaert I
- Schotborgh CE
- Ferdinande B
- van der Harst P
- Roosen J
- Peper J
- Thielen FWF
- Veenstra L
- Chan Pin Yin DRPP
- Swaans MJ
- Rensing BJWM
- van ’t Hof AWJ
- Timmers L
- Kelder JC
- Stella PR
- Baan J
- ten Berg JM
Aspirin with or without clopidogrel after transcatheter aortic-valve implantation.
[published online ahead of print, 2020 Aug 30].
N Engl J Med. 2020; (10.1056/NEJMoa2017815)https://doi.org/10.1056/NEJMoa2017815
3
,
4
,
- Rodés-Cabau J
- Masson J-B
- Welsh RC
- del Blanco BG
- Pelletier M
- Webb JG
- Al-Qoofi F
- Généreux P
- Maluenda G
- Thoenes M
Aspirin versus aspirin plus clopidogrel as antithrombotic treatment following transcatheter
aortic valve replacement with a balloon-expandable valve: the ARTE (Aspirin Versus
Aspirin+ Clopidogrel Following Transcatheter Aortic Valve Implantation) randomized
clinical trial.
JACC: Cardiovasc Interv. 2017; 10: 1357-1365
5
Therefore, we conducted a meta-analysis of all randomized controlled trials (RCTs)
to assess the safety and efficacy of DAPT versus aspirin monotherapy after TAVI.To read this article in full you will need to make a payment
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References
- 2017 ACC expert consensus decision pathway for transcatheter aortic valve replacement in the management of adults with aortic stenosis.J Am Coll Cardiol. 2017; 69: 1313-1346
- Aspirin with or without clopidogrel after transcatheter aortic-valve implantation. [published online ahead of print, 2020 Aug 30].N Engl J Med. 2020; (10.1056/NEJMoa2017815)https://doi.org/10.1056/NEJMoa2017815
- SAT-TAVI (Single Antiplatelet Therapy for TAVI) study: a randomized study comparing double to single antiplatelet therapy for transcatheter aortic valve implantation.J Am Coll Cardiol. 2011; 58: B218
- Aspirin versus aspirin plus clopidogrel as antithrombotic treatment following transcatheter aortic valve replacement with a balloon-expandable valve: the ARTE (Aspirin Versus Aspirin+ Clopidogrel Following Transcatheter Aortic Valve Implantation) randomized clinical trial.JACC: Cardiovasc Interv. 2017; 10: 1357-1365
- Dual antiplatelet therapy versus aspirin alone in patients undergoing transcatheter aortic valve implantation.Am J Cardiol. 2011; 108: 1772-1776
Article Info
Publication History
Published online: September 19, 2020
Received in revised form:
September 10,
2020
Received:
September 2,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
