Antithrombotic therapy in patients undergoing transcatheter aortic valve implantation

Nijenhuis, Vincent J.; Brouwer, Jorn; Søndergaard, Lars; Collet, Jean‐Philippe; Grove, Erik Lerkevang; Berg, Jürrien M. ten

doi:10.1136/heartjnl-2018-314313

Cited by 28 publications

(24 citation statements)

References 54 publications

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“…The main independent indication for antiplatelet therapy is chronic coronary syndrome, which affects up to 40% of TAVI patients, followed by acute coronary syndrome, peripheral artery disease and large aortic arch atheroma. [118][119][120] In these patients, routine administration of OAC should be avoided. In the most complex scenario of patients in whom the absolute indications for antiplatelets and OAC merge, the matter becomes convoluted.…”

Section: Patients Requiring Antiplatelet Therapy After Transcatheter mentioning

confidence: 99%

Anticoagulation after Transcatheter Aortic Valve Implantation: Current Status

Greco

Capodanno

2020

Interv Cardiol

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Transcatheter aortic valve implantation (TAVI) is the standard of care for symptomatic severe aortic stenosis. Antithrombotic therapy is required after TAVI to prevent thrombotic complications but it increases the risk of bleeding events. Current clinical guidelines are mostly driven by expert opinion and therefore yield low-grade recommendations. The optimal antithrombotic regimen following TAVI has yet to be determined and several randomised controlled trials assessing this issue are ongoing. The purpose of this article is to critically explore the impact of antithrombotic drugs, especially anticoagulants, on long-term clinical outcomes following successful TAVI.

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Section: Patients Requiring Antiplatelet Therapy After Transcatheter mentioning

confidence: 99%

Anticoagulation after Transcatheter Aortic Valve Implantation: Current Status

Greco

Capodanno

2020

Interv Cardiol

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“… 38 However, in TAVR patients with AF, anticoagulant therapy is designed to reduce the risk of thrombotic events. 39 A previous study sought to evaluate the management patterns and clinical outcomes of patients with new-onset AF who underwent TAVR. Patients were followed for 1 year.…”

Section: Anticoagulant Therapymentioning

confidence: 99%

Optimal antithrombotic therapy after transcatheter aortic valve replacement in patients with atrial fibrillation

Zeng

Cheng

Xia

et al. 2020

Therapeutic Advances in Chronic Disease

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Atrial fibrillation (AF) is prevalent in patients with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). Depending on the timing of AF detection, it is usually categorized as pre-existing AF or new-onset AF. Antiplatelet therapy, rather than a vitamin K antagonist, may be considered as the primary treatment for patients without an indication for oral anticoagulants who undergo TAVR. However, the optimal postprocedural antithrombotic regimen for patients with AF undergoing TAVR remains unknown. In this review, we briefly introduce the management strategies of antithrombotic therapy and list the evidence from related studies to elucidate the optimal antithrombotic management for patients with AF undergoing TAVR.

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“…Taken together, the larger randomized TAVI trials including patients with intermediate to high risk show that major and life-threatening bleeding exceeds by far the incidence of ischemic events like stroke or myocardial infarction over time (Fig. 3) [55].…”

Section: Valvular Heart Diseasementioning

confidence: 99%

Necessity of Antiaggregation and Anticoagulation and Its Prognostic Impact: A Cardiologist’s View

Hink

Voigtländer

2020

Visc Med

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Background: In modern cardiology, anticoagulation and antiaggregation are key components of current treatment strategies. However, in patients treated with anticoagulation and antiplatelet substances, bleeding is a major risk. Findings: In all major cardiovascular diseases, a multitude of studies have shown a positive impact of antithrombotic treatment on cardiovascular death. In patients with higher bleeding risks, recent studies showed the safety of reducing the period of dual antiplatelet therapy (DAPT), i.e., after percutaneous coronary intervention. In patients with coronary artery disease and atrial fibrillation (AF), triple therapy including DAPT and anticoagulation is associated with very high bleeding risks. However, recently published data showed the safety of direct oral anticoagulants (DOACs) and P2Y12 inhibitors only compared to vitamin K antagonist (VKA) and DAPT. Anticoagulation in nonvalvular AF reduces major cerebrovascular ischemic events. However, the inherent cerebrovascular bleeding risk is an important concern of this treatment. With the advent of DOACs, this risk could be reduced compared to VKA. Furthermore, anticoagulation and antiaggregation are crucial after treatment of valve disease, both after surgical and interventional procedures. Even in heart failure, new data show benefits using antithrombot-ic substances. Conclusions: Anticoagulation and antiaggregation are of major prognostic relevance in cardiovascular diseases. However, the inherent bleeding risk has to be considered.

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Antithrombotic therapy in patients undergoing transcatheter aortic valve implantation

Cited by 28 publications

References 54 publications

Anticoagulation after Transcatheter Aortic Valve Implantation: Current Status

Anticoagulation after Transcatheter Aortic Valve Implantation: Current Status

Optimal antithrombotic therapy after transcatheter aortic valve replacement in patients with atrial fibrillation

Necessity of Antiaggregation and Anticoagulation and Its Prognostic Impact: A Cardiologist’s View

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