Antiplatelet Therapy in TAVI: Current Clinical Practice and Recommendations

Author(s): Nikolaos A. Magkoutis , Sabi Fradi , Alexandre Azmoun , Ramsi Ramadan , Sami Ben Ouanes , Manolis Vavuranakis , Dimitrios A. Vrachatis , Theodore G. Papaioannou , Dimitrios Tousoulis , Saïd Ghostine .

Journal Name: Current Pharmaceutical Design

Volume 22 , Issue 13 , 2016

Abstract:

Transcatheter aortic valve implantation (TAVI) is all the more used therapeutic option for patients suffering from symptomatic severe aortic valvular stenosis declined by surgeons because of high surgical risk. Given the high bleeding and ischemic risk of this vulnerable population, their antithrombotic treatment becomes a crucial issue. There is no consensus on antithrombotic treatment after TAVI and dual antiplatelet therapy (DAPT) with aspirin (indefinitely) and clopidogrel (1-6 months) is, in general, recommended. With regards to patients with an indication for oral anticoagulation (OAC), a combination of OAC plus aspirin or clopidogrel is commonly suggested. This review underscores that it is extremely difficult to compare different antithrombotic regimens in patients undergoing TAVI because of their variable demographic characteristics. Nevertheless, available data suggest that DAPT results to more bleeding events. Still, whether it positively affects ischemic episodes is doubtful. Ongoing trials are expected to draw a clearer picture on the field.

Keywords: TAVR, PAVI, PAVR, bioprosthesis, anticoagulation, OAC, clopidogrel, aspirin.

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Article Details

VOLUME: 22
ISSUE: 13
Year: 2016
Page: [1888 - 1895]
Pages: 8
DOI: 10.2174/1381612822666160222115936
Price: $58

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