No Antithrombotic Therapy After Transcatheter Aortic Valve Replacement

医学 抗血栓 阿司匹林 氯吡格雷 内科学 阀门更换 入射(几何) 心脏病学 心肌梗塞 冲程(发动机) 养生 外科 狭窄 工程类 物理 光学 机械工程
作者
Yusuke Kobari,Taku Inohara,Hikaru Tsuruta,Fumiaki Yashima,Hideyuki Shimizu,Keiichi Fukuda,Toru Naganuma,Kazuki Mizutani,Masahiro Yamawaki,Norio Tada,Futoshi Yamanaka,Shinichi Shirai,Minoru Tabata,Hiroshi Ueno,Kensuke Takagi,Yusuke Watanabe,Masanori Yamamoto,Kentaro Hayashida
出处
期刊:Jacc-cardiovascular Interventions [Elsevier BV]
卷期号:16 (1): 79-91 被引量:20
标识
DOI:10.1016/j.jcin.2022.10.010
摘要

Several trials demonstrated that aspirin monotherapy compared with aspirin plus clopidogrel is associated with a lower incidence of bleeding without an increased risk of ischemic events in patients after transcatheter aortic valve replacement (TAVR); however, there remains a paucity of data to prove the necessity of even aspirin monotherapy.This study aimed to compare clinical outcomes and valve performance of the 3 different antithrombotic strategies post-TAVR from the OCEAN-TAVI (Optimized transCathEter vAlvular iNtervention) registry.Patients who received anticoagulation or had procedural complications were excluded. The remaining patients were classified into 3 groups according to the antithrombotic regimen at discharge: 1) nonantithrombotic therapy (None); 2) single-antiplatelet therapy (SAPT); and 3) dual-antiplatelet therapy (DAPT). The primary outcome was the incidence of net adverse clinical events (NACEs) (ie, cardiovascular death, stroke, myocardial infarction, and life-threatening or major bleeding).Overall, 3,575 TAVR patients were included (None, 293; SAPT, 1,354; DAPT, 1,928). The median follow-up period was 841 days (IQR: 597-1,340 days). The incidence of NACEs did not differ between the groups (None vs SAPT: adjusted HR [aHR]: 1.18; P = 0.45; None vs DAPT: aHR: 1.09; P = 0.67). There was a lower incidence of all bleeding in patients with no antithrombotics (None vs SAPT: aHR: 0.63; P = 0.12; None vs DAPT: aHR: 0.51; P = 0.04). The valve performance was similar among the groups. Leaflet thrombosis was detected in 8.5% of the nonantithrombotic group.Compared with SAPT/DAPT, the nonantithrombotic strategy was not associated with an increased risk of NACEs and potentially reduced the risk of bleeding events. The nonantithrombotic strategy may be an acceptable alternative to SAPT/DAPT in selected patients with TAVR.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
tjfwg发布了新的文献求助10
1秒前
hhhhhh发布了新的文献求助10
2秒前
ding应助fengliurencai采纳,获得10
3秒前
荔枝完成签到 ,获得积分10
3秒前
4秒前
幸福大白发布了新的文献求助10
4秒前
hanleiharry1发布了新的文献求助10
5秒前
时笙发布了新的文献求助10
6秒前
8秒前
8秒前
翻斗花园小美完成签到,获得积分10
9秒前
11秒前
共享精神应助讨厌科研采纳,获得10
12秒前
余南发布了新的文献求助10
12秒前
13秒前
李子发布了新的文献求助10
13秒前
14秒前
量子星尘发布了新的文献求助10
16秒前
16秒前
16秒前
双楠应助SAVP采纳,获得10
17秒前
oui发布了新的文献求助10
18秒前
朴实桐应助花痴的语堂采纳,获得10
18秒前
18秒前
科目三应助东晓采纳,获得10
19秒前
loski发布了新的文献求助10
19秒前
清爽如雪完成签到 ,获得积分10
19秒前
Orange应助hanleiharry1采纳,获得10
22秒前
王海海发布了新的文献求助10
22秒前
23秒前
Xin发布了新的文献求助10
23秒前
mrx完成签到,获得积分20
24秒前
25秒前
孙燕应助光热效应采纳,获得30
28秒前
朴实桐应助花痴的语堂采纳,获得10
29秒前
香香完成签到,获得积分10
30秒前
大脑袋媛媛完成签到,获得积分10
31秒前
夏日发布了新的文献求助10
33秒前
33秒前
hanleiharry1发布了新的文献求助10
34秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989390
求助须知:如何正确求助?哪些是违规求助? 3531487
关于积分的说明 11254109
捐赠科研通 3270153
什么是DOI,文献DOI怎么找? 1804887
邀请新用户注册赠送积分活动 882087
科研通“疑难数据库(出版商)”最低求助积分说明 809174