Τίτλος:
Antithrombotic therapy in TAVI
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Transcatheter aortic valve implantation (TAVI) carries a significant thromboembolic and concomitant bleeding risk, not only during the procedure but also during the periprocedural period. Many issues concerning optimal antithrombotic therapy after TAVI are still under debate. In the present review, we aimed to identify all relevant studies evaluating antithrombotic therapeutic strategies in relation to clinical outcomes after the procedure. Four randomized control trials (RCT) were identified analyzing the post-TAVI antithrombotic strategy with all of them utilizing aspirin lifelong plus clopidogrel for 36 months. Seventeen registries have been identified, with a wide variance among them regarding baseline characteristics, while concerning antiplatelet therapy, clopidogrel duration was ranging from 312 months. Four non-randomized trials were identified, comparing single vs. dual antiplatelet therapy after TAVI, in respect of investigating thromboembolic outcome events over bleeding complications. Finally, limited data from a single RCT and a retrospective study exist with regards to anticoagulant treatment during the procedure and the optimal antithrombotic therapy when concomitant atrial fibrillation. In conclusion, due to the high risk and frailty of the treated population, antithrombotic therapy after TAVI should be carefully evaluated. Diminishing ischaemic and bleeding complications remains the main challenge in these patients with further studies to be needed in this field. © 2018 JGC All rights reserved.
Συγγραφείς:
Vavuranakis, M.
Kalogeras, K.
Kolokathis, A.M.
Vrachatis, D.
Magkoutis, N.
Siasos, G.
Oikonomou, E.
Kariori, M.
Papaioannou, T.
Lavda, M.
Moldovan, C.
Katsarou, O.
Tousoulis, D.
Περιοδικό:
The American Journal of Geriatric Cardiology
Εκδότης:
Social Science Press
Λέξεις-κλειδιά:
acenocoumarol; acetylsalicylic acid; anticoagulant agent; antithrombocytic agent; apixaban; bivalirudin; clopidogrel; dabigatran; edoxaban; heparin; prasugrel; rivaroxaban; ticagrelor, anticoagulant therapy; aortic stenosis; aortic valve replacement; atrial fibrillation; bleeding; cerebrovascular accident; chemoprophylaxis; drug efficacy; dual antiplatelet therapy; heart infarction; human; occlusive cerebrovascular disease; practice guideline; Review; surgical risk; systematic review; thromboembolism; transcatheter aortic valve implantation; treatment duration; treatment outcome
DOI:
10.11909/j.issn.1671-5411.2018.01.001
