Antiplatelet Therapy in TAVI: Current Clinical Practice and Recommendations

Title:Antiplatelet Therapy in TAVI: Current Clinical Practice and Recommendations

Volume: 22 Issue: 13

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

Affiliation:

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

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.

Cite this article as:

Magkoutis A. Nikolaos, Fradi Sabi, Azmoun Alexandre, Ramadan Ramsi, Ben Ouanes Sami, Vavuranakis Manolis, Vrachatis A. Dimitrios, Papaioannou G. Theodore, Tousoulis Dimitrios and Ghostine Saïd, Antiplatelet Therapy in TAVI: Current Clinical Practice and Recommendations, Current Pharmaceutical Design 2016; 22 (13) . https://dx.doi.org/10.2174/1381612822666160222115936