Impact of Antithrombotic Regimen on Mortality, Ischemic, and Bleeding Outcomes after Transcatheter Aortic Valve Replacement

Cardiology and Therapy
Anubodh VarshneyRobert Giugliano

Abstract

Optimal antithrombotic therapy after transcatheter aortic valve replacement (TAVR) remains unclear. We evaluated the association between antithrombotic regimens and outcomes in TAVR patients. We retrospectively analyzed consecutive patients who underwent TAVR at a single academic center from April 2009 to March 2014. Antithrombotic regimens were classified as single or dual antiplatelet therapy (AP), single antiplatelet plus anticoagulant (SAC), or triple therapy (TT). The primary endpoint was a composite of death, myocardial infarction (MI), stroke, and major bleeding. Adjusted hazard ratios (HRs) were obtained with best subset variable selection methods using bootstrap resampling. Of 246 patients who underwent TAVR, 241 were eligible for analysis with 133, 88, and 20 patients in the AP, SAC, and TT groups, respectively. During a median 2.1-year follow-up, 53.5% had at least one endpoint-the most common was death (68%), followed by major bleeding (23%), stroke (6%), and MI (3%). At 2 years, the composite outcome occurred in 70% of TT, 42% of SAC, and 31% of AP patients. Compared to AP, adjusted HRs for the composite outcome were 2.88 [95% Confidence intervals (CI) (1.61-5.16); p = 0.0004] and 1.66 (95% CI [1.13-2.42]; p = 0.00...Continue Reading

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Citations

Jul 18, 2018·Minerva cardioangiologica·Arthur Shiyovich, Ran Kornowski
Oct 15, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Toshiki KunoSripal Bangalore
May 10, 2020·Interventional Cardiology·Antonio Greco, Davide Capodanno

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Clinical Trials Mentioned

NCT02664649
NCT01642134
NCT02735902
NCT02943785
NCT02556203
NCT02247128
NCT02817789

Software Mentioned

GALILEO
POPular
TAVR
TAVI
ENVISAGE
TICTAVR
SAS

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