Edoxaban vs. Dual Antiplatelet Therapy After Transcatheter Aortic Valve Replacement

The optimal anticoagulation and antiplatelet regimen after transcatheter aortic valve replacement (TAVR) remains an area of active debate. Current guidelines recommend 3–6 months of dual antiplatelet therapy and suggest a possible role for oral anticoagulation among patients at low risk for bleeding, but these recommendations are based largely on historical practice and expert opinion. Although use of the direct oral anticoagulant (DOAC) rivaroxaban has been shown to reduce the rate of leaflet thrombosis, this benefit occurred on a background of aspirin therapy and was associated with an unacceptably high risk for bleeding complications and excess mortality (NEJM JW Cardiol Jan 2020 and N Engl J Med 2020; 382:130). Now, researchers report f…