Aspirin with or without clopidogrel after transcatheter aortic-valve implantation
New England Journal of Medicine Sep 03, 2020
Brouwer J, Nijenhuis VJ, Delewi R, et al. - To ascertain the impact of single vs dual antiplatelet treatment on bleeding as well as thromboembolic events following transcatheter aortic-valve implantation (TAVI) among patients who did not have an indication for long-term anticoagulation, researchers undertook this randomized, controlled trial. A subgroup of patients who were receiving TAVI and did not have an indication for long-term anticoagulation were assigned, in a 1:1 ratio, to receive aspirin alone or aspirin plus clopidogrel for 3 months. All bleeding (including minor, major, and life-threatening or disabling bleeding) and non–procedure-related bleeding during a span of 12 months were primary outcomes. Findings revealed that treatment with aspirin for 3 months was associated with significantly less frequent incidence of bleeding and the composite of bleeding or thromboembolic events at 1 year, in comparison with treatment with aspirin plus clopidogrel, in patients receiving TAVI who did not have an indication for oral anticoagulation.
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