Key result
Aspirin plus ticagrelor achieved non-HPR status at 90 days in 100% of patients undergoing TAVR compared with 21% for aspirin plus clopidogrel (p<0.001).
Why the study?
Current recommendations support short-term aspirin plus clopidogrel after TAVR despite lacking compelling evidence, leaving the comparative efficacy of clopidogrel versus ticagrelor for suppressing high platelet reactivity unclear.
Does aspirin + ticagrelor improve suppression of high platelet reactivity compared to aspirin + clopidogrel in patients with aortic stenosis undergoing TAVR?
RCT (n=68)
Yes
Does aspirin + ticagrelor improve suppression of high platelet reactivity compared to aspirin + clopidogrel in patients with aortic stenosis undergoing TAVR?
Absolute Event Rate: 100% vs 21%
p-value: p=<0.001
Ticagrelor provides better and faster suppression of high platelet reactivity compared to clopidogrel in patients undergoing TAVR.
No takes yet. Share an insight, caveat, or question.
May support ticagrelor-based DAPT for platelet inhibition post-TAVR; hypothesis-generating and requires RCT confirmation before practice change.
Díaz et al. (2019) conducted an RCT in Aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) (n=68). Aspirin + ticagrelor vs. Aspirin + clopidogrel was evaluated on Non-HPR status (PRU <208) at 90 days post-TAVR (p=<0.001). Aspirin plus ticagrelor achieved non-HPR status at 90 days in 100% of patients undergoing TAVR compared with 21% for aspirin plus clopidogrel (p<0.001).