TY  - BOOK
AU  - Ben-Dor, Itsik
AU  - Case, Brian
AU  - Forrestal, Brian
AU  - Mintz, Gary S
AU  - Rogers, Toby
AU  - Satler, Lowell F
AU  - Waksman, Ron
AU  - Yerasi, Charan
TI  - Usefulness of Antiplatelet Therapy After Transcatheter Aortic Valve Implantation. [Review]
SN  - 0002-9149
PY  - 2021///
KW  - *Aortic Valve Stenosis/su [Surgery]
KW  - *Dual Anti-Platelet Therapy/mt [Methods]
KW  - *Hemorrhage/ci [Chemically Induced]
KW  - *Mortality
KW  - *Platelet Aggregation Inhibitors/tu [Therapeutic Use]
KW  - *Stroke/ep [Epidemiology]
KW  - *Thrombosis/pc [Prevention & Control]
KW  - *Transcatheter Aortic Valve Replacement
KW  - Aspirin/tu [Therapeutic Use]
KW  - Cause of Death
KW  - Clopidogrel/tu [Therapeutic Use]
KW  - Endothelium
KW  - Evidence-Based Medicine
KW  - Hemorrhage/ep [Epidemiology]
KW  - Humans
KW  - Thrombosis/ep [Epidemiology]
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Interventional Cardiology Fellowship
KW  - MedStar Heart & Vascular Institut
KW  - Journal Article
KW  - Review
N2  - The rationale for dual antiplatelet therapy (DAPT) after transcatheter aortic valve implantation (TAVI) is to facilitate endothelialization of metallic struts of the transcatheter heart valve and to prevent thrombosis that could lead to thromboembolic events. Based on expert consensus, current societal guidelines recommend DAPT for 1 to 6 months after TAVI with weak evidence. Although the pivotal TAVI trials mandated this regimen, the evidence for the efficacy of DAPT to prevent transcatheter heart valve thrombosis is limited to 3 small trials and a handful of observational studies. Multiple coronary trials have demonstrated that DAPT is associated with increased bleeding in comparison with single antiplatelet therapy, especially in elderly patients. TAVI patients are predominantly elderly and frequently have risk factors that predispose them to bleeding. Herein, we summarize the evidence for antiplatelet therapy after TAVI and explore the theoretical benefit of DAPT to prevent thromboembolic events versus the risk of increased bleeding. Copyright (c) 2021 Elsevier Inc. All rights reserved
UR  - https://dx.doi.org/10.1016/j.amjcard.2021.03.010
ER  -