Key result
Aspirin alone reduces bleeding ~43% versus aspirin plus clopidogrel in TAVI patients.
Why the study?
Does aspirin alone reduce bleeding and thromboembolic events compared to aspirin plus clopidogrel in patients undergoing TAVI without an indication for oral anticoagulation?
RCT (n=665)
null
1:1 ratio
Yes
Does aspirin alone reduce bleeding and thromboembolic events compared to aspirin plus clopidogrel in patients undergoing TAVI without an indication for oral anticoagulation?
Effect estimate: RR 0.57 (95% CI 0.42 to 0.77)
Absolute Event Rate: 15.1% vs 26.6%
p-value: p=0.001
In patients undergoing TAVI without an indication for oral anticoagulation, aspirin alone significantly reduces bleeding and composite bleeding/thromboembolic events at 1 year compared to dual antiplatelet therapy with aspirin and clopidogrel.
Supports aspirin monotherapy to reduce bleeding after TAVI; challenges prior recommendations for dual antiplatelet therapy.
Among patients undergoing TAVI who did not have an indication for oral anticoagulation, the incidence of bleeding and the composite of bleeding or thromboembolic events at 1 year were significantly less frequent with aspirin than with aspirin plus clopidogrel administered for 3 months. (Funded by the Netherlands Organization for Health Research and Development; POPular TAVI EU Clinical Trials Register number, 2013-003125-28; ClinicalTrials.gov number, NCT02247128.).
No takes yet. Share an insight, caveat, or question.
Brouwer et al. (2020) conducted an RCT in Transcatheter Aortic-Valve Implantation (n=665). Aspirin vs. Aspirin plus Clopidogrel was evaluated on All bleeding (RR 0.57, 95% CI 0.42 to 0.77, p=0.001). Aspirin alone reduced all bleeding events by 42.9% compared to aspirin plus clopidogrel in patients undergoing TAVI at 12 months follow-up.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: