email article
A direct oral anticoagulant (DOAC) was no better than existing antithrombotic treatments after transcatheter aortic valve replacement (TAVR), according to ATLANTIS trial investigators.
TAVR patients randomized to apixaban (Eliquis) instead of antiplatelet therapy or warfarin saw no reduction in the trial s primary endpoint, a composite of death, MI, stroke, systemic emboli, intracardiac or bioprosthesis thrombus, episode of deep vein thrombosis (DVT) or pulmonary embolism (PE), and major bleeding over 1-year follow-up (18.4% vs 20.1%, HR 0.92, 95% CI 0.73-1.16).
These findings were consistent whether patients had an indication for oral anticoagulation or not, reported Jean-Philippe Collet, MD, PhD, of Pitié-Salpêtrière Hospital in Paris, at the American College of Cardiology (ACC) virtual meeting.
February 09, 2021
Two additional randomized trials along with other analyses published since 2018 have helped to firm up formal guidance around antithrombotic therapy in patients with atrial fibrillation (AF) who are undergoing PCI.
Published yesterday, the updated North American consensus statement continues to recommend triple therapy with a direct oral anticoagulant (DOAC), a P2Y12 inhibitor, and aspirin during the peri-PCI period, after which the aspirin should be discontinued, according to experts from the United States and Canada.
That’s similar to what the group recommended in the last update published in 2018, but the publication of the AUGUSTUS and ENTRUST-AF PCI trials in the past few years “provides a lot of reassurance on the importance of an early discontinuation of aspirin in these patients,” lead author Dominick Angiolillo, MD, PhD (University of Florida College of Medicine – Jacksonville), told TCTMD.