May 17, 2021
Use of apixaban (Eliquis; Bristol-Myers Squibb) following transcatheter aortic valve implantation does not significantly reduce the risk of subclinical valve thrombosis when compared with standard of care, according to a CT substudy from the ATLANTIS trial presented today.
However, the results are nuanced, with investigators reporting an intriguing interaction between thrombus risk and prior oral anticoagulation indication. For patients without an indication for oral anticoagulation, use of apixaban as opposed to antiplatelet therapy was associated with a lower risk of subclinical valve thrombosis as measured by reduced leaflet motion (RLM) and hypoattenuated leaflet thickening (HALT).
By contrast, for those with an indication for oral anticoagulation, apixaban failed to prevent subclinical valve thrombosis when compared with a vitamin K antagonist.