Faculty of Medicine
Library of the School of Health Sciences

2023-11-09

2023

Kalantzis Charalampos

Σιάσος Γεράσιμος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Τούσουλης Δημήτριος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Βαβουρανάκης Εμμανουήλ, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Τσιούφης Κωνσταντίνος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αγγέλη Κωνσταντίνα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Τσιάμης Ελευθέριος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Τσιαχρής Δημήτριος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ

Αποτελεσματικότητα της διπλής αντιαιμοπεταλιακής αγωγής με ασπιρίνη και τικαγρελόρη στην πρόληψη εμβολικών εγκεφαλικών επεισοδίων σε ασθενείς που υποβάλλονται σε διακαθετηριακή εμφύτευση βιοπροσθετικής αορτικής βαλβίδας συγκριτικά με ασθενείς που λαμβάνουν ασπιρίνη και κλοπιδογρέλη, όπως εκτιμάται από την ανίχνευση παροδικών εμβολικών σημάτων υψηλής έντασης στη ροή των μέσων εγκεφαλικών αρτηριών

Greek

Efficacy of dual antiplatelet therapy with aspirin and ticagrelor in preventing embolic strokes in patients undergoing transcatheter bioprosthetic aortic valve implantation compared with patients receiving aspirin and clopidogrel as assessed by detection of high-intensity transient embolic signals in middle cerebral arteries flow

Background: The impact of the antiplatelet regimen and the extent of associated platelet inhibition on cerebrovascular microembolic events during TAVI are unknown.

Methods: Patients scheduled for TAVI were randomized prior to the procedure to either aspirin and clopidogrel or to aspirin and ticagrelor. High intensity transient signals (HITS) were assessed with transcranial Doppler (TCD). Safety outcomes were recorded according to the VARC-2 definitions.

Results: Among 90 patients randomized, 8 had poor TCD signal. In total, 82 patients equally divided in the 2 groups were enrolled (mean age 81,1 ± 7 years, 63,4% males) with severe symptomatic aortic stenosis. The total number of procedural HITS was greater in the clopidogrel group (679 ± 214) than in the ticagrelor group (410 ± 108), p< 0.001. After adjustments for the duration of the procedure, diabetes type 2, extra-cardiac arteriopathy and aortic valve calcium content, patients on ticagrelor had on average 255.9 (95% CI: [ -335.4, -176.4]) fewer total procedural HITS in comparison to the patients who were on clopidogrel.

Conclusion: Ticagrelor resulted in fewer procedural HITS, compared to clopidogrel, in patients undergoing TAVI.

Health Sciences

Transcatheter aortic valve implantation, Stroke, Antiplatelet therapy, Transcranial Doppler

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Yes

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https://pergamos.lib.uoa.gr/uoa/dl/object/3364119