Key result
Antithrombotic policy for patients undergoing TAVI is highly variable across 14 Dutch hospitals, with all centers prescribing aspirin but varying in their use and duration of concomitant clopidogrel.
Cross-Sectional (n=14)
Yes
There is high inter-centre variability in antithrombotic policies for patients undergoing TAVI in the Netherlands, highlighting the need for standardized regimens and large randomized trials.
Variability in post-TAVI antithrombotic policies across Dutch centers signals practice heterogeneity; leaves open the preferred regimen pending randomized trials.
PURPOSE: To assess current antithrombotic treatment strategies in the Netherlands in patients undergoing transcatheter aortic valve implantation (TAVI). METHODS: For every Dutch hospital performing TAVI (n = 14) an interventional cardiologist experienced in performing TAVI was interviewed concerning heparin, aspirin, thienopyridine and oral anticoagulation treatment in patients undergoing TAVI. RESULTS: The response rate was 100 %. In every centre, a protocol for antithrombotic treatment after TAVI was available. Aspirin was prescribed in all centres, concomitant clopidogrel was prescribed 13 of the 14 centres. Duration of concomitant clopidogrel was 3 months in over two-thirds of cases. In 2 centres, duration of concomitant clopidogrel was based upon type of prosthesis: 6 months versus 3 months for supra-annular and intra-annular prostheses, respectively. CONCLUSIONS: Leaning on a small basis of evidence and recommendations, the antithrombotic policy for patients undergoing TAVI is highly variable in the Netherlands. As a standardised regimen might further reduce haemorrhagic complications, large randomised clinical trials may help to establish the most appropriate approach.
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Nijenhuis et al. (2013) conducted a cross-sectional in Antithrombotic treatment strategies in patients undergoing TAVI (n=14). Antithrombotic treatment strategies was evaluated on Antithrombotic treatment protocols. Antithrombotic policy for patients undergoing TAVI is highly variable across 14 Dutch hospitals, with all centers prescribing aspirin but varying in their use and duration of concomitant clopidogrel.
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