Pre-procedural dual antiplatelet therapy in patients undergoing transcatheter aortic valve implantation increases risk of bleeding

Hioki, Hirofumi; Watanabe, Yusuke; Kozuma, Ken; Nara, Yugo; Kawashima, Hideyuki; Kataoka, Akihisa; Yamamoto, Masanori; Takagi, Kensuke; Araki, Motoharu; Tada, Norio; Shirai, Shinichi; Yamanaka, Futoshi; Hayashida, Kentaro

doi:10.1136/heartjnl-2016-309735

Cited by 59 publications

(35 citation statements)

References 29 publications

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“…Patients' characteristics and the outcomes in the present study are comparable to those reported in other Japanese studies. 7,11,24, 25 On the other hand, despite similar mean STS scores, the mortality and readmission rates in the present study were lower than those of a US registry, probably because of our learning curve. 26 This present data did not include our initial experience with patients who were in the Japanese trial that began in 2010.…”

Section: Impact Of Frailty Markers In Tavicontrasting

confidence: 51%

Impact of Frailty Markers for Unplanned Hospital Readmission Following Transcatheter Aortic Valve Implantation

Higuchi

Tobaru

Iguchi

et al. 2018

Circ J

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Section: Impact Of Frailty Markers In Tavicontrasting

confidence: 51%

Impact of Frailty Markers for Unplanned Hospital Readmission Following Transcatheter Aortic Valve Implantation

Higuchi

Tobaru

Iguchi

et al. 2018

Circ J

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“…Staged PCI before TAVR may limit TAVR duration and contrast media volume compared with concomitant PCI. However, it imposes a pre‐procedural use of dual antiplatelet therapy, which may be associated with an increased risk of hemorrhagic complications . Further studies, such as the ACTIVATION trial are warranted to better define the optimal management of this high‐risk population.…”

Section: Discussionmentioning

confidence: 99%

Impact of coronary artery disease and percutaneous coronary intervention in women undergoing transcatheter aortic valve replacement: From the WIN‐TAVI registry

Guedeney

Tchétché

Petronio

et al. 2018

Cathet Cardio Intervent

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Objectives: To evaluate the impact of coronary artery disease (CAD) with or without recent (≤ 30 days) percutaneous coronary intervention (PCI) in women undergoing transcatheter aortic valve replacement (TAVR).Background: Although women display a specific risk-profile for both PCI and TAVR, the impact of CAD and PCI in the setting of TAVR in women is unclear. Methods:The multinational Women's International Transcatheter Aortic Valve implantation registry enrolled consecutive female patients undergoing contemporary TAVR in 19 centers between 2013 and 2015. Patients with available coronary angiography or CT scan in the pre-operative assessment of TAVR were categorized as without CAD, with CAD but no recent PCI and CAD and recent PCI (≤30 days). All events were adjudicated according to the VARC-2 criteria.Results: A total of 787 patients were included in this analysis, among whom 459 (58.3%) had no CAD, 247 (31.4%) had CAD without recent PCI and 81 (10.3%) underwent recent PCI (≤ 30 days before TAVR). After multivariable adjustment, both groups of CAD patients, without and with recent PCI, presented with higher risk of death, myocardial infarction or stroke, compared with patients without CAD ( adj HR 1.56, 95%CI 1.03-2.39, P = 0.038 and adj HR 1.96, 95% CI 1.1-3.5, P = .021, respectively). Patients with recent PCI had increased risk of all-cause death ( adj HR 1.89, 95% CI 1.0-3.5, P = 0.04) and stroke ( adj HR 3.7, 95% CI 1.0-13.5, P = 0.046) compared with patients without CAD. Conclusion:The presence of CAD in women undergoing TAVR, with or without recent PCI, was associated with long-term poorer outcomes. K E Y W O R D Saortic stenosis, gender issue, transcatheter aortic valve replacement

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“…Patients with no pre-procedure antiplatelet did not have an increase in thromboembolic risk. 20 Compared to DAPT, aspirin alone was associated with lower composite outcomes and bleeding in these small studies. Larger clinical trials are necessary to assess the comparative efficacy of aspirin alone versus DAPT versus oral anticoagulation based strategies to achieve optimal outcomes after TAVR .…”

Section: Subclinical and Clinical Leaflet Thrombosismentioning

confidence: 71%

“…In multivariate analysis, DAPT before TF‐TAVR significantly increased bleeding compared with SAPT (adjusted OR 2.05, P = 0.014) and no antiplatelet therapy (adjusted OR 2.30, P = 0.031). Patients with no pre‐procedure antiplatelet did not have an increase in thromboembolic risk Compared to DAPT, aspirin alone was associated with lower composite outcomes and bleeding in these small studies.…”

Section: Adjunctive Therapies and Imaging In Tavrmentioning

confidence: 99%

Transcatheter aortic valve replacement: The year in review 2017

Thakur

Nazif

Khalique

et al. 2018

J Interven Cardiology

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This article is a continuation of our previously published annual reviews of transcatheter aortic valve replacement (TAVR). In 2017, TAVR further established a foothold in the management of intermediate risk patients with the publication of SURTAVI trial. Randomized trials also addressed the use of cerebral protection during TAVR and single versus dual antiplatelet therapy after TAVR. Newer generation valve systems continued to be studied for their efficacy and safety. This paper summarizes the major studies published in 2017.

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Pre-procedural dual antiplatelet therapy in patients undergoing transcatheter aortic valve implantation increases risk of bleeding

Abstract: UMIN-ID; 000020423; Results.

Cited by 59 publications

References 29 publications

Impact of Frailty Markers for Unplanned Hospital Readmission Following Transcatheter Aortic Valve Implantation

Impact of Frailty Markers for Unplanned Hospital Readmission Following Transcatheter Aortic Valve Implantation

Impact of coronary artery disease and percutaneous coronary intervention in women undergoing transcatheter aortic valve replacement: From the WIN‐TAVI registry

Transcatheter aortic valve replacement: The year in review 2017

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