Antiplatelet and antithrombotic treatment after transcatheter aortic valve implantation - comparison of regimes.
J Invasive Cardiol
; 25(10): 544-8, 2013 Oct.
Article
en En
| MEDLINE
| ID: mdl-24088430
ABSTRACT
OBJECTIVES:
We compared procedural and follow-up complications of TAVI patients based on the type of antithrombotic treatment used (single-antiplatelet [SAPT] vs dual-antiplatelet [DAPT] vs warfarin).BACKGROUND:
Despite growing operator experience and device development, vascular complications following transcatheter aortic valve implantation (TAVI) remain problematic. Bleeding complications and stroke are two of the main disadvantages compared with surgical aortic valve replacement. Correct choice of antiplatelet or antithrombotic treatment is therefore crucial, but remains empirical.METHODS:
We analyzed a cohort of 171 patients with symptomatic severe aortic stenosis who underwent TAVI using the CoreValve (Medtronic, Inc) in our center between December 2007 and June 2012. We assessed both procedural, in-hospital, and follow-up outcomes for vascular complications, stroke, myocardial infarction, bleeding complications, and death.RESULTS:
Patients were aged 81.6 ± 6.4 years; 47% were male. Treatment regimes were DAPT (34%), SAPT (53%), or warfarin (13%). When analyzing the combined endpoint of all-cause death, acute coronary events, stroke, or bleeding, the outcome was significantly worse in the DAPT group (in-hospital P=.01, 30-day follow-up P=.02). This difference was driven mainly by bleeding complications, with a trend toward higher rates of major bleeding events in the DAPT group vs SAPT group (P=.07 for both in-hospital and 30-day bleeding). The occurrence of major adverse cardiac and cerebrovascular events was statistically similar in all groups.CONCLUSION:
This relatively small series suggests that DAPT does not protect patients from stroke, but may expose them to higher bleeding risk. Further study of this area is warranted.
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Base de datos:
MEDLINE
Asunto principal:
Estenosis de la Válvula Aórtica
/
Trombosis
/
Inhibidores de Agregación Plaquetaria
/
Cateterismo Cardíaco
/
Implantación de Prótesis de Válvulas Cardíacas
/
Fibrinolíticos
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged80
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Invasive Cardiol
Asunto de la revista:
CARDIOLOGIA
Año:
2013
Tipo del documento:
Article
País de afiliación:
Reino Unido