The impact of antiplatelet and antithrombotic regimen after TAVI

Abstract

The correct antiplatelet (ATP) and anticoagulant therapy (ACT), as well as its indications, combinations and contraindications, are well studied and controversial key elements in the management of patients undergoing cardiac surgery. 1,2 Besides off-pump procedures, the majority of cardiac operations depend on cardiopulmonary bypass with systemic

Antithrombotic Therapy After Transcatheter Aortic Valve Replacement: An Overview

“… 85 Analysis of data from the Vienna Registry (VIenna CardioThOracic Aortic Valve RegistrY trial) showed a trend toward improved 3-year survival in patients on non-VKA OACs compared to those on a VKA regimen. 86 Additionally, a recent study involving over 21,000 patients enrolled in the STS/ACC Transcatheter Valve Therapy Registry registry showed that in patients post-TAVR with AF, DOAC use has a comparable stroke risk with lower incidence of bleeding, intracranial hemorrhage, and death at 1 year compared with VKA therapy. 87 While much of the literature suggests that DOAC therapy is a potentially safe alternative to VKA therapy, there are still only a small number of nonrandomized studies examining this.…”

“…Another study analyzing data from the VIenna CardioThOracic Aortic Valve RegistrY trial found that patients receiving no treatment (20 patients) had similar overall CV and cerebrovascular mortality between 1 and 5 ​years of follow-up when compared to groups receiving SAPT (172 patients), DAPT (34 patients), and OAC (163 patients) therapy. 86 Due to the small sample size, no further analysis was possible for this patient cohort.…”