No Antithrombotic Therapy After Transcatheter Aortic Valve Replacement: Insight From the OCEAN-TAVI Registry
Source : https://www.sciencedirect.com/science/article/abs/pii/S1936879822018982?via=ihub
Several trials demonstrated that aspirin monotherapy compared with aspirin plus clopidogrel is associated with a lower incidence of bleeding without an increased risk of ischemic events in patients after transcatheter aortic valve replacement (TAVR); however, there remains a paucity of data to prove the necessity of even aspirin monotherapy.
Conclusions: Compared with SAPT/DAPT, the nonantithrombotic strategy was not associated with an increased risk of NACEs and potentially reduced the risk of bleeding events. The nonantithrombotic strategy may be an acceptable alternative to SAPT/DAPT in selected patients with TAVR.
• Source: JACC
• Conclusion: “Compared with SAPT/DAPT, the non-antithrombotic strategy was not associated with an increased risk of NACEs and potentially reduced the risk of bleeding events. The non-antithrombotic strategy may be an acceptable alternative to SAPT/DAPT in selected patients with TAVR.”
• In total, 3,575 TAVR patients were categorized into 3 groups according to the antithrombotic regimen at discharge: 1) non-antithrombotic therapy (None); 2) single-antiplatelet therapy (SAPT); and 3) dual-antiplatelet therapy (DAPT). The primary end point for the study was the incidence of net adverse clinical events (NACEs) (i.e., cardiovascular death, stroke, myocardial infarction, and life-threatening or major bleeding).
• The incidence of NACEs did not differ between the groups, and there was a lower incidence of all bleeding in patients taking no antithrombotics. Furthermore, the valve performance was comparable among the groups. The researchers detected leaflet thrombosis in 8.5% of the non-antithrombotic group.