Format

Send to

Choose Destination
Heart. 2015 Jul;101(14):1118-25. doi: 10.1136/heartjnl-2014-307053. Epub 2015 May 6.

Antiplatelet therapy following transcatheter aortic valve implantation.

Author information

1
Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
2
Department of Cardiology, Brighton and Sussex University Hospitals, Sussex, UK.
3
Department of Cardiology, University hospital of Rouen, Hospital Charles Nicolle, Rouen, France.
4
Department of Advanced Biomedical Sciences, University of Napoli "Federico II", Napoli, Italy.
5
Cardiologia Interventistica Strutturale Policlinico Tor Vergata, Università degli Studi di Roma Tor Vergata, Roma, Italy.
6
Laboratory of Invasive Cardiology, Clinica Montevergine, Mercogliano, Italy.
7
Department of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy.
8
Department of Cardiology, University Paris descartes, AP-HP; European Georges Pompidou Hospital, Paris, France.

Abstract

OBJECTIVE:

There is limited evidence to support decision making on antiplatelet therapy following transcatheter aortic valve implantation (TAVI). Our aim was to assess the efficacy and safety of aspirin-only (ASA) versus dual antiplatelet therapy (DAPT) following TAVI.

METHODS:

We performed a systematic review and pooled analysis of individual patient data from 672 participants comparing single versus DAPT following TAVI. Primary endpoint was defined as the composite of net adverse clinical and cerebral events (NACE) at 1 month, including all-cause mortality, acute coronary syndrome (ACS), stroke, life-threatening and major bleeding.

RESULTS:

At 30 days a NACE rate of 13% was observed in the ASA-only and in 15% of the DAPT group (OR 0.83, 95% CI 0.48 to 1.43, p=0.50). A tendency towards less life-threatening and major bleeding was observed in patients treated with ASA (OR 0.56, 95% CI 0.28 to 1.11, p=0.09). Also, ASA was not associated with an increased all-cause mortality (OR 0.91, 95% CI 0.36 to 2.27, p=0.83), ACS (OR 0.5, 95% CI 0.05 to 5.51, p=0.57) or stroke (OR 1.21; 95% CI 0.36 to 4.03, p=0.75).

CONCLUSIONS:

No difference in 30-day NACE rate was observed between ASA-only or DAPT following TAVI. Moreover, a trend towards less life-threatening and major bleeding was observed in favour of ASA. Consequently the additive value of clopidogrel warrants further investigation.

PMID:
25948421
DOI:
10.1136/heartjnl-2014-307053
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center