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Antiplatelet therapy following transcatheter aortic valve implantation
- Source :
- Heart (British Cardiac Society), 101(14), 1118-1125. BMJ Publishing Group
- Publication Year :
- 2015
- Publisher :
- BMJ, 2015.
-
Abstract
- Objective There is limited evidence to support decision making on antiplatelet therapy following transcatheter aortic valve implantation (TAVI). Our aim was to assess the efficacy and safety of aspirin-only (ASA) versus dual antiplatelet therapy (DAPT) following TAVI. Methods We performed a systematic review and pooled analysis of individual patient data from 672 participants comparing single versus DAPT following TAVI. Primary endpoint was defined as the composite of net adverse clinical and cerebral events (NACE) at 1 month, including all-cause mortality, acute coronary syndrome (ACS), stroke, life-threatening and major bleeding. Results At 30 days a NACE rate of 13% was observed in the ASA-only and in 15% of the DAPT group (OR 0.83, 95% CI 0.48 to 1.43, p=0.50). A tendency towards less life-threatening and major bleeding was observed in patients treated with ASA (OR 0.56, 95% CI 0.28 to 1.11, p=0.09). Also, ASA was not associated with an increased all-cause mortality (OR 0.91, 95% CI 0.36 to 2.27, p=0.83), ACS (OR 0.5, 95% CI 0.05 to 5.51, p=0.57) or stroke (OR 1.21; 95% CI 0.36 to 4.03, p=0.75). Conclusions No difference in 30-day NACE rate was observed between ASA-only or DAPT following TAVI. Moreover, a trend towards less life-threatening and major bleeding was observed in favour of ASA. Consequently the additive value of clopidogrel warrants further investigation.
- Subjects :
- Male
Cardiac Catheterization
Acute coronary syndrome
medicine.medical_specialty
Ticlopidine
Time Factors
Time Factor
Hemorrhage
Risk Assessment
Pharmacotherapy
Risk Factors
Internal medicine
Epidemiology
Odds Ratio
Clinical endpoint
Humans
Medicine
Acute Coronary Syndrome
Stroke
Aged
Aged, 80 and over
Heart Valve Prosthesis Implantation
Aspirin
business.industry
Platelet Aggregation Inhibitor
Risk Factor
Aortic Valve Stenosis
Odds ratio
Clopidogrel
medicine.disease
Aortic Valve Stenosi
Treatment Outcome
Meta-analysis
Cardiology
Drug Therapy, Combination
Female
Cardiology and Cardiovascular Medicine
business
Platelet Aggregation Inhibitors
Human
medicine.drug
Subjects
Details
- ISSN :
- 1468201X and 13556037
- Volume :
- 101
- Database :
- OpenAIRE
- Journal :
- Heart
- Accession number :
- edsair.doi.dedup.....29e04b4ad30db1a6572687a49c2450e5