scholarly journals Antithrombotic Therapy for Prevention of Cerebral Thromboembolic Events After Transcatheter Aortic Valve Replacement

2017 ◽  
Vol 10 (13) ◽  
pp. 1366-1369 ◽  
Author(s):  
Davide Capodanno ◽  
Dominick J. Angiolillo
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Antithrombotic Therapy ◽  
Transcatheter Aortic Valve Replacement ◽  
Thromboembolic Events ◽  
Transcatheter Aortic Valve

scholarly journals Antithrombotic Therapy After Transcatheter Aortic Valve Replacement

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Paul Guedeney ◽  
Roxana Mehran ◽  
Jean-Philippe Collet ◽  
Bimmer E. Claessen ◽  
Jurriën ten Berg ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Antithrombotic Therapy ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve

scholarly journals Comparative efficacy and safety of antithrombotic therapy for transcatheter aortic valve replacement: a systematic review and network meta-analysis

2019 ◽  
Vol 57 (5) ◽  
pp. 965-976 ◽  
Author(s):  
Yuexin Zhu ◽  
Ziyuan Zou ◽  
Yusi Huang ◽  
Lei Zhang ◽  
Huiting Chen ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Antiplatelet Therapy ◽  
Valve Replacement ◽  
Antithrombotic Therapy ◽  
Transcatheter Aortic Valve Replacement ◽  
Meta Analysis ◽  
Treatment Modalities ◽  
Transcatheter Aortic Valve ◽  
Increased Risk

Abstract OBJECTIVES We sought to determine the optimal antithrombotic therapy after transcatheter aortic valve replacement. METHODS Related scientific databases were searched until December 2018. We conducted a pairwise and a network meta-analysis within a frequentist framework, measuring 30-day bleeding, stroke and all-cause mortality. The surface under the cumulative ranking (SUCRA) curve was estimated to rank the therapies. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was performed. The protocol was registered with PROSPERO (CRD42018111163). RESULTS Eight studies comprising 2173 patients were analysed. The risk of 30-day bleeding was higher for dual antiplatelet therapy (DAPT) than single antiplatelet therapy (SAPT) [odds ratio (OR) 1.90 (1.10–3.28); P = 0.02], whereas there was no difference in the risk of 30-day stroke [OR 1.27 (0.38–4.20); P = 0.69] and mortality [OR 1.46 (0.67–3.22); P = 0.34] between DAPT and SAPT. In the network meta-analysis, DAPT + oral anticoagulant (OAC) increased the risk of 30-day bleeding compared with SAPT [OR 6.21 (1.74–22.17); P = 0.005], DAPT [OR 3.27 (1.04–10.32); P = 0.043], SAPT + OAC [OR 4.87 (2.51–9.45); P < 0.001] and OAC [OR 14.4 (1.3–154.7); P = 0.028]. Additionally, patients receiving DAPT + OAC had the highest risks for 30-day bleeding (SUCRA 1.0%). OAC seemed to be superior to SAPT and DAPT in terms of 30-day bleeding (SUCRA OAC: 86.3%, SAPT: 72.3%, DAPT: 32.3%) and stroke (SUCRA 54.2%, 47.4%, 40.5%), but not mortality (SUCRA 69.6%, 74.1%, 43.4%). CONCLUSIONS There is a trend towards less bleeding with the application of SAPT, but no mortality benefit with the application of DAPT is shown. The comparison of SAPT, DAPT and OAC shows that OAC may improve the balance between stroke and bleeding, which can reduce the risk of mortality. In addition, the application of DAPT + OAC was ranked the worst amongst all treatment modalities and should be avoided due to an increased risk of bleeding. Clinical trial registration number PROSPERO (International Prospective Register of Systematic Reviews, CRD42018111163).

Antithrombotic therapy after transcatheter aortic valve replacement

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Janine Eckstein ◽  
Shuangbo Liu ◽  
Olga Toleva ◽  
Bobby Yanagawa ◽  
Subodh Verma ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Antithrombotic Therapy ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve
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