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https://www.readbyqxmd.com/read/29580827/dual-antiplatelet-therapy-versus-single-antiplatelet-therapy-after-transaortic-valve-replacement-meta-analysis
#1
Abdulah Alrifai, Mohamad Soud, Amjad Kabach, Yash Jobanputra, Abdulrahman Masrani, Saleh El Dassouki, M Chadi Alraies, Zaher Fanari
BACKGROUND: The current guidelines recommend empirical therapy with DAPT of aspirin and clopidogrel for six months after TAVR. This recommendation is based on expert consensus only. Giving the lack of clear consensus on treatment strategy following TAVR. Goal of this meta-analysis is to assess the efficacy and safety of mono-antiplatelet therapy (MAPT) versus dual antiplatelet therapy (DAPT) following transcatheter aortic valve replacement (TAVR). METHODS AND MATERIALS: We performed a meta-analysis from randomized clinical trials (RCTs) and prospective studies that tested DAPT vs...
March 16, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29516608/comparison-of-single-versus-dual-antiplatelet-therapy-after-tavr-a-systematic-review-and-meta-analysis
#2
Hitesh Raheja, Aakash Garg, Sunny Goel, Kinjal Banerjee, Gerald Hollander, Jacob Shani, Stephanie Mick, Jonathan White, Amar Krishnaswamy, Samir Kapadia
OBJECTIVE: We aim to evaluate the efficacy of dual versus single anti-platelet therapy (SAPT) after TAVR through a systematic review and meta-analysis of published research. BACKGROUND: Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel is a commonly practiced strategy after transcatheter aortic valve replacement (TAVR). However, there is lack of sufficient evidence supporting this approach. METHOD: We searched PubMed, EMBASE, the Cochrane Central Register of Controlled trials, and the clinical trial registry maintained at clinicaltrials...
March 8, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29478129/gene-polymorphisms-in-dual-antiplatelet-therapy-and-the-presence-of-hypo-attenuated-leaflet-thickening-after-transcatheter-aortic-valve-replacement
#3
Tian-Yuan Xiong, Yan-Biao Liao, Yuan Feng, Ming-Yue Zhao, Zhen-Gang Zhao, Yi-Jian Li, Xiao-Jing Liu, Mao Chen
The imaging finding of hypo-attenuated leaflet thickening (HALT) on bioprosthesis after transcatheter aortic valve replacement (TAVR) has been reported. The underlying mechanism is not clear, but leaflet thrombosis is speculated to be the cause. Heterogeneous antiplatelet responses may play a role in the process. This is a prospective, single-center pilot study in patients who received successful TAVR from June 2012 to November 2016. HALT on post-procedural multi-detector computed tomography. We thoroughly genotyped 34 SNPs and 8 SNPs that have been reported for clopidogrel and aspirin resistance...
February 24, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29345593/antithrombotic-therapy-after-tavr
#4
Tobias Geisler, Michal Droppa, Karin Mueller, Oliver Borst
Transvascular aortic valve replacement (TAVR) has emerged as a treatment option in patients with severe aortic stenosis who are inoperable and has recently been evaluated in patients with intermediate surgical risk. The number of procedures is increasing worldwide in parallel with the demographic changes in industrial countries. The risk for cerebral embolism is of main concern and represents a major determinant for prognosis and quality of live after TAVR. The empiric antithrombotic therapy consists of dual antiplatelet therapy (DAPT); however the risk-benefit of this approach is lacking evidence from randomized, placebo-controlled trials regarding choice and duration of antithrombotic treatment...
January 17, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29304514/antithrombotic-treatment-after-transcatheter-heart-valves-implant
#5
Sabato Sorrentino, Gennaro Giustino, Kamilia Moalem, Ciro Indolfi, Roxana Mehran, George D Dangas
Transcatheter heart valve replacement technology was introduced as alternative to surgery for the growing high-risk profile population. Developed first, aortic valve replacement (TAVR) became a standard of care for patients with severe aortic stenosis at high operative risk, with a potential future use also for low-risk subjects. In the last decade, a multitude of transcatheter mitral valve replacement (TMVR) devices have been developed for the treatment of severe mitral regurgitation, with encouraging results coming from first-in-man and feasibility studies...
February 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29276174/routine-use-of-anticoagulation-after-transcatheter-aortic-valve-replacement-initial-safety-outcomes-from-a-single-center-experience
#6
Sergey Gurevich, Brett Oestreich, Rosemary F Kelly, Mackenzie Mbai, Stefan Bertog, Demetris Yannopoulos, Santiago Garcia
BACKGROUND: Subclinical leaflet thrombosis (SCLT) can be seen in up to 12% of patients after transcatheter aortic valve replacement (TAVR). Anticoagulation appears to prevent and reverse SCLT but concerns exist about bleeding risk. METHODS: Our program adopted a strategy of routine anticoagulation after TAVR, starting warfarin on post-procedure day 0 and continuing for 3months in 10/2015. We report the initial safety and efficacy outcomes of this approach. Bleeding events were assessed using Valve Academic Research Consortium (VARC) and Bleeding Academic Research Consortium (BARC) definitions...
December 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29121410/medication-management-of-patients-undergoing-transcatheter-aortic-valve-replacement
#7
REVIEW
Bethany A Kalich, J Erin Allender, Ian B Hollis
Aortic stenosis (AS) is the most common form of valvular heart disease. A detailed diagnostic workup is necessary to promptly stage and classify disease severity to determine optimal management. Medical therapy and valvuloplasty are options that fail to delay or reverse disease progression. Surgical aortic valve replacement (SAVR) is curative but has significant limitations for some patient populations. A newer option, transcatheter aortic valve replacement (TAVR), has become more widely available to patients with intermediate- or high-operative risk...
January 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/28943264/could-anticoagulation-avoid-bioprosthesis-subclinical-thrombosis-in-patients-undergoing-transcatheter-aortic-valve-replacement
#8
François Huchet, Vincent Letocart, Patrice Guerin, Caroline Cueff, Julie Roy-Giocosa, Béatrice Guyomarch-Delasalle, Philippe Jaafar, Thibaut Manigold
BACKGROUND: Despite a lack of clear evidence, current European guidelines recommend antiplatelet therapy after transcatheter aortic valve replacement (TAVR). Recent investigations suggest that bioprosthesis thrombosis after TAVR is not uncommon and may be prevented by anticoagulation, but not by antiplatelet therapy. AIMS: The study objective was to assess the impact of the antithrombotic regimen on post-TAVR early haemodynamics. METHODS: Patients eligible for TAVR with an Edwards SAPIEN 3 valve were included in this prospective observational study...
January 2018: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28734880/dual-versus-single-antiplatelet-regimen-with-or-without-anticoagulation-in-transcatheter-aortic-valve-replacement-indirect-comparison-and-meta-analysis
#9
Monica Verdoia, Lucia Barbieri, Matteo Nardin, Harry Suryapranata, Giuseppe De Luca
INTRODUCTION AND OBJECTIVES: There is uncertainty on the correct management of antithrombotic therapies after transcatheter aortic valve replacement (TAVR), with dual antiplatelet therapy (DAPT) being currently recommended on an empirical basis. The aim of the present meta-analysis was to assess the safety and effectiveness of DAPT in patients undergoing TAVR. METHODS: Studies comparing different antithrombotic regimens after TAVR were included. The primary endpoint was 30-day overall mortality...
July 19, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28527771/aspirin-versus-aspirin-plus-clopidogrel-as-antithrombotic-treatment-following-transcatheter-aortic-valve-replacement-with-a-balloon-expandable-valve-the-arte-aspirin-versus-aspirin-clopidogrel-following-transcatheter-aortic-valve-implantation-randomized-clinical
#10
Josep Rodés-Cabau, Jean-Bernard Masson, Robert C Welsh, Bruno Garcia Del Blanco, Marc Pelletier, John G Webb, Faisal Al-Qoofi, Philippe Généreux, Gabriel Maluenda, Martin Thoenes, Jean-Michel Paradis, Chekrallah Chamandi, Vicenç Serra, Eric Dumont, Mélanie Côté
OBJECTIVES: The aim of this study was to compare aspirin plus clopidogrel with aspirin alone as antithrombotic treatment following transcatheter aortic valve replacement (TAVR) for the prevention of ischemic events, bleeding events, and death. BACKGROUND: Few data exist on the optimal antithrombotic therapy following TAVR. METHODS: This was a randomized controlled trial comparing aspirin (80 to 100 mg/day) plus clopidogrel (75 mg/day) (dual antiplatelet therapy [DAPT]) versus aspirin alone (single-antiplatelet therapy [SAPT]) in patients undergoing TAVR with a balloon-expandable valve...
July 10, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28497845/comparison-of-dual-antiplatelet-therapy-versus-oral-anticoagulation-following-transcatheter-aortic-valve-replacement-a-retrospective-single-center-registry-analysis
#11
Erik W Holy, Julia Kebernik, Abdelhakim Allali, Mohamed El-Mawardy, Gert Richardt, Mohamed Abdel-Wahab
BACKGROUND: The choice of optimal antithrombotic regimen after transcatheter aortic valve replace-ment (TAVR) remains a matter of debate. The objective of this study was to compare both efficacy and safety outcomes based on the type of antithrombotic therapy prescribed after TAVR Methods: This is a retrospective analysis of 514 consecutive patients treated with either dual antiplate¬let therapy (DAPT) (n = 315; 61.3%) or oral anticoagulation (OAC) plus clopidogrel (n = 199; 38.7%) for a minimum of 3 months after TAVR followed by antiplatelet monotherapy or OAC only, respectively...
2017: Cardiology Journal
https://www.readbyqxmd.com/read/28391560/adjuvant-antithrombotic-therapy-in-tavr
#12
REVIEW
Ryan G O'Malley, Kenneth W Mahaffey, William F Fearon
PURPOSE OF REVIEW: Transcatheter aortic valve replacement (TAVR) has developed into an important alternative to surgical aortic valve replacement (SAVR) for patients with severe aortic stenosis (AS). Adjuvant antithrombotic therapies are commonly used during and after TAVR to decrease the risk of valve thrombosis and thromboembolic cerebrovascular events (CVEs) but consequently increase the risk of bleeding. This article reviews the past and current clinical data regarding adjuvant antithrombotic therapies in TAVR...
May 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28376985/a-clinical-review-of-surgical-vs-transcatheter-aortic-valve-replacement-in-geriatric-patients
#13
REVIEW
Laura V Tsu, Andrew J Berry, Neda Krunic, Sarah Penny, Sonny Le
OBJECTIVE: To provide an up-to-date review of the available evidence regarding management of elderly patients after transcatheter aortic valve replacement (TAVR). DATA SOURCES: A PubMed search of articles published (September 1969-December 2016) was done using a combination of the following words: aortic valve stenosis, geriatric, elderly, transcatheter aortic valve replacement, surgical aortic valve replacement, transcatheter aortic valve implantation (TAVI), and dual antiplatelet therapy...
April 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28330690/subclinical-leaflet-thrombosis-in-surgical-and-transcatheter-bioprosthetic-aortic-valves-an-observational-study
#14
Tarun Chakravarty, Lars Søndergaard, John Friedman, Ole De Backer, Daniel Berman, Klaus F Kofoed, Hasan Jilaihawi, Takahiro Shiota, Yigal Abramowitz, Troels H Jørgensen, Tanya Rami, Sharjeel Israr, Gregory Fontana, Martina de Knegt, Andreas Fuchs, Patrick Lyden, Alfredo Trento, Deepak L Bhatt, Martin B Leon, Raj R Makkar
BACKGROUND: Subclinical leaflet thrombosis of bioprosthetic aortic valves after transcatheter valve replacement (TAVR) and surgical aortic valve replacement (SAVR) has been found with CT imaging. The objective of this study was to report the prevalence of subclinical leaflet thrombosis in surgical and transcatheter aortic valves and the effect of novel oral anticoagulants (NOACs) on the subclinical leaflet thrombosis and subsequent valve haemodynamics and clinical outcomes on the basis of two registries of patients who had CT imaging done after TAVR or SAVR...
June 17, 2017: Lancet
https://www.readbyqxmd.com/read/27892890/trial-design-rivaroxaban-for-the-prevention-of-major-cardiovascular-events-after-transcatheter-aortic-valve-replacement-rationale-and-design-of-the-galileo-study
#15
RANDOMIZED CONTROLLED TRIAL
Stephan Windecker, Jan Tijssen, Gennaro Giustino, Ana H C Guimarães, Roxana Mehran, Marco Valgimigli, Pascal Vranckx, Robert C Welsh, Usman Baber, Gerrit-Anne van Es, Peter Wildgoose, Albert A Volkl, Ana Zazula, Karen Thomitzek, Melanie Hemmrich, George D Dangas
BACKGROUND: Optimal antithrombotic treatment after transcatheter aortic valve replacement (TAVR) is unknown and determined empirically. The direct factor Xa inhibitor rivaroxaban may potentially reduce TAVR-related thrombotic complications and premature valve failure. DESIGN: GALILEO is an international, randomized, open-label, event-driven, phase III trial in more than 1,520 patients without an indication for oral anticoagulation who underwent a successful TAVR (ClinicalTrials...
February 2017: American Heart Journal
https://www.readbyqxmd.com/read/27601428/insights-into-timing-risk-factors-and-outcomes-of-stroke-and-transient-ischemic-attack-after-transcatheter-aortic-valve-replacement-in-the-partner-trial-placement-of-aortic-transcatheter-valves
#16
RANDOMIZED CONTROLLED TRIAL
Samir Kapadia, Shikhar Agarwal, D Craig Miller, John G Webb, Michael Mack, Stephen Ellis, Howard C Herrmann, Augusto D Pichard, E Murat Tuzcu, Lars G Svensson, Craig R Smith, Jeevanantham Rajeswaran, John Ehrlinger, Susheel Kodali, Raj Makkar, Vinod H Thourani, Eugene H Blackstone, Martin B Leon
BACKGROUND: Prior studies of stroke and transient ischemic attack (TIA) after transcatheter aortic valve replacement (TAVR) are limited by reporting and follow-up variability. This is a comprehensive analysis of time-related incidence, risk factors, and outcomes of these events. METHODS AND RESULTS: From April 2007 to February 2012, 2621 patients, aged 84±7.2 years, underwent transfemoral (TF; 1521) or transapical (TA; 1100) TAVR in the PARTNER trial (Placement of Aortic Transcatheter Valves; as-treated), including the continued access registry...
September 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27539691/warfarin-and-antiplatelet-therapy-versus%C3%A2-warfarin-alone-for-treating-patients%C3%A2-with%C3%A2-atrial-fibrillation-undergoing-transcatheter-aortic-valve-replacement
#17
MULTICENTER STUDY
Omar Abdul-Jawad Altisent, Eric Durand, Antonio J Muñoz-García, Luis Nombela-Franco, Asim Cheema, Joelle Kefer, Enrique Gutierrez, Luis M Benítez, Ignacio J Amat-Santos, Vicenç Serra, Helene Eltchaninoff, Sami M Alnasser, Jaime Elízaga, Antonio Dager, Bruno García Del Blanco, Maria Del Rosario Ortas-Nadal, Josep Ramon Marsal, Francisco Campelo-Parada, Ander Regueiro, Maria Del Trigo, Eric Dumont, Rishi Puri, Josep Rodés-Cabau
OBJECTIVES: The study sought to examine the risk of ischemic events and bleeding episodes associated with differing antithrombotic strategies in patients undergoing transcatheter aortic valve replacement (TAVR) with concomitant atrial fibrillation (AF). BACKGROUND: Guidelines recommend antiplatelet therapy (APT) post-TAVR to reduce the risk of stroke. However, data on the efficacy and safety of this recommendation in the setting of a concomitant indication for oral anticoagulation (due to atrial fibrillation [AF]) with a vitamin K antagonist (VKA) are scarce...
August 22, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27208464/cerebral-embolism-during-transcatheter%C3%A2-aortic-valve-replacement-the-bravo-3-mri-study
#18
RANDOMIZED CONTROLLED TRIAL
Eric Van Belle, Christian Hengstenberg, Thierry Lefevre, Christian Kupatt, Nicolas Debry, Oliver Husser, François Pontana, Grégory Kuchcinski, Efthymios N Deliargyris, Roxana Mehran, Debra Bernstein, Prodromos Anthopoulos, George D Dangas
BACKGROUND: Cerebral embolization is a frequent complication after transcatheter aortic valve replacement (TAVR). We hypothesized that cerebral embolization may be reduced by anticoagulation with bivalirudin during TAVR. OBJECTIVES: This study sought to determine the proportion of patients with new cerebral embolus after TAVR and to investigate whether parenteral procedural anticoagulation strategies affect cerebral embolization. METHODS: The BRAVO (Effect of Bivalirudin on Aortic Valve Intervention Outcomes)-3 randomized trial compared bivalirudin with unfractionated heparin in patients undergoing transfemoral TAVR...
August 9, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27085389/the-risk-and-extent-of-neurologic-events-are-equivalent-for-high-risk-patients-treated-with-transcatheter-or-surgical-aortic-valve-replacement
#19
RANDOMIZED CONTROLLED TRIAL
Thomas G Gleason, John T Schindler, David H Adams, Michael J Reardon, Neal S Kleiman, Louis R Caplan, John V Conte, G Michael Deeb, G Chad Hughes, Sharla Chenoweth, Jeffrey J Popma
OBJECTIVES: This study was designed to characterize the incidence of new clinically detectable neurologic events, or any comparative change in indices of higher cognitive function following transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) within the framework of a prospective, randomized clinical trial for high-risk patients. METHODS: High-risk patients (predicted SAVR mortality 15%) with severe aortic stenosis (n = 750) were randomized 1:1 to TAVR or SAVR and underwent evaluation using the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale assessment at each follow-up and any suspected event...
July 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/26946696/-cardiology-update-in-2015
#20
Patrizio Pascale, Julien Regamey, Juan F Iglesias, Vincent Gabus, Mathieu Clair, Patrick Yerly, Roger Hullin, Olivier Müller, Éric Eeckhout, Pierre Vogt
The present review provides a selected choice of clinical trials and therapeutic advances in the field of cardiology in 2015. A new treatment option in heart failure will become available this year in Switzerland. In interventional cardiology, new trials have been published on the duration of dual antiplatelet therapy, the new stents with bioresorbable scaffold and the long-term results of TAVR in patients who are not surgical candidates or at high surgical risk. RegardingAF the BRIDGE trial provides new evidences to guide the management of patients during warfarin interruption for surgery...
January 13, 2016: Revue Médicale Suisse
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