Key result
SAPT proves safer and noninferior to DAPT in post-TAVR patients without oral anticoagulation indication.
Why the study?
The optimal antithrombotic regimen following TAVR remains unknown and inconsistently applied amid complex thromboembolic, frailty, bleeding, and comorbidity considerations.
What is the optimal antithrombotic regimen following transcatheter aortic valve replacement?
What is the optimal antithrombotic regimen following transcatheter aortic valve replacement?
This review summarizes current evidence on antithrombotic regimens post-TAVR to help minimize morbidity and mortality in a generally frail and elderly patient population.
May support single over dual antiplatelet therapy post-TAVR without anticoagulation indication; leaves open confirmation in randomized trials.
Transcatheter aortic valve replacement (TAVR) is an established procedure for the treatment of patients with severe aortic stenosis. The optimal antithrombotic regimen following TAVR, currently unknown and inconsistently applied, is impacted by thromboembolic risk, frailty, bleeding risk, and comorbidities. There is a quickly growing body of literature examining the complex issues underlying antithrombotic regimens post-TAVR. This review provides an overview of thromboembolic and bleeding events following TAVR, summarizes the evidence regarding optimal antiplatelet and anticoagulant use post-TAVR, and highlights current challenges and future directions. By understanding appropriate indications and outcomes associated with different antithrombotic regimens post-TAVR, morbidity and mortality can be minimized in a generally frail and elderly patient population.
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Hindi et al. (2022) conducted a review in Severe aortic stenosis (post-TAVR). Antithrombotic therapy was evaluated. Recent evidence suggests that single antiplatelet therapy provides a safer and noninferior approach compared to dual antiplatelet therapy for patients undergoing TAVR without an indication for chronic oral anticoagulation.
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