Anticoagulation with or without Clopidogrel after Transcatheter Aortic-Valve Implantation
Why the study?
Does oral anticoagulation alone reduce serious bleeding compared to oral anticoagulation plus clopidogrel in patients undergoing TAVI who are receiving oral anticoagulation?
Population
Patients undergoing TAVI who were receiving oral anticoagulation
Comparison
Oral anticoagulation alone vs oral anticoagulation plus clopidogrel
Follow-up
1 month or 1 year
Authors
Discussion
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Member takes
Implication
Supports omitting clopidogrel after TAVI in patients on oral anticoagulation to lower bleeding; challenges dual antithrombotic therapy as standard.
Key Points
- To evaluate the safety and bleeding outcomes of oral anticoagulation alone compared with oral anticoagulation combined with clopidogrel in patients undergoing transcatheter aortic-valve implantation (TAVI).
- Randomized clinical trial (ClinicalTrials.gov NCT02247128; EU 2013-003125-28) conducted in patients undergoing TAVI who had an existing indication for oral anticoagulation.
- Patients received either oral anticoagulation alone or oral anticoagulation combined with clopidogrel.
- Outcomes were tracked over follow-up intervals of 1 month and 1 year.
- Oral anticoagulation alone significantly reduced the incidence of serious bleeding compared with oral anticoagulation plus clopidogrel at both 1 month and 1 year (numerical event rates, hazard ratios, and p-values not specified in abstract).
Structured PICO
Does oral anticoagulation alone reduce serious bleeding compared to oral anticoagulation plus clopidogrel in patients undergoing TAVI who are receiving oral anticoagulation?
P
Population
Patients undergoing transcatheter aortic-valve implantation (TAVI) who were receiving oral anticoagulation
I
Intervention
Oral anticoagulation alone
C
Comparator
Oral anticoagulation plus clopidogrel
O
Outcome
Incidence of serious bleeding over a period of 1 month or 1 yearsafety
In patients undergoing TAVI who require oral anticoagulation, omitting clopidogrel reduces the incidence of serious bleeding at 1 month and 1 year.
Cite This Study
Nijenhuis et al. (2020) studied this question.