Single or Dual Antiplatelet Therapy After Transcatheter Aortic Valve Implantation?

A new randomized trial suggests that single antiplatelet therapy may be the best option.

Guidelines recommend 3 to 6 months of dual antiplatelet therapy after transcatheter aortic valve replacement (TAVR) (NEJM JW Cardiol Apr 24 2017), but this approach is based on expert opinion and has not been tested in large-scale randomized trials. Given the advanced age and multiple comorbidities often present in patients undergoing TAVR, bleeding complications are a major concern. Thus, reducing the duration and intensity of antithrombotic therapy is desirable.

To investigate this issue, the POPular TAVI investigators performed a randomized, open-label clinical trial (NCT02247128) among patients undergoing TAVR who did not have a pre-procedure indication for oral anticoagulation. After exclusion of patients who did not undergo TAVR or wit…

Reviewing Author

David J. Cohen, MD, MSc

Disclosures

Consultant/Advisory BoardMedtronic; Edwards Lifesciences; Abbott Vascular; Boston Scientific; St. Francis Hospital

Speaker’s BureauBoston Scientific; ZOLL Medical

Grant/Research SupportEdwards Lifesciences; Abbott Vascular; Boston Scientific; Corvia Medical; National Heart, Lung, and Blood Institute; Phillips, Inc.; St. Paul’s Hospital; V-Wave, Inc; ZOLL Medical; CathWorks, ANCORA

Editorial BoardsJACC; American Heart Journal; EuroIntervention; JSCAI; Structural Heart Journal

Leadership Positions in Professional SocietiesSociety of Thoracic Surgeons/American College of Cardiology TVT Registry (Co-Chair, Risk Model Development Committee); Cardiovascular Research Foundation (Co-Director, TCT Annual Meeting; Co-Director, New York Valves Annual Meeting)