Antithrombotic therapy in TAVI patients: changing concepts.

Gargiulo, Giuseppe; Collet, Jean-Philippe; Valgimigli, Marco (2015). Antithrombotic therapy in TAVI patients: changing concepts. EuroIntervention, 11(SupplW), W92-W95. Europa Digital & Publishing 10.4244/EIJV11SWA28

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The clinical and demographic characteristics of patients undergoing TAVI pose unique challenges for developing and implementing optimal antithrombotic therapy. Ischaemic and bleeding events in the periprocedural period and months after TAVI still remain a relevant concern to be faced with optimised antithrombotic therapy. Moreover, the antiplatelet and anticoagulant pharmacopeia has evolved significantly in recent years with new drugs and multiple possible combinations. Dual antiplatelet therapy (DAPT) is currently recommended after TAVI with oral anticoagulation (OAC) restricted for specific indications. However, atrial fibrillation (which is often clinically silent and unrecognised) is common after the procedure and embolic material often thrombin-rich. Recent evidence has therefore questioned this approach, suggesting that DAPT may be futile compared with aspirin alone and that OAC could be a relevant alternative. Future randomised and appropriately powered trials comparing different regimens of antithrombotic therapy, including new antiplatelet and anticoagulant agents, are warranted to increase the available evidence on this topic and create appropriate recommendations for this frail population. Meanwhile, it remains rational to adhere to current guidelines, with routine DAPT and recourse to OAC when specifically indicated, whilst always tailoring therapy on the basis of individual bleeding and thromboembolic risk.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Gargiulo, Giuseppe and Valgimigli, Marco


600 Technology > 610 Medicine & health




Europa Digital & Publishing




Daria Vogelsang

Date Deposited:

06 Apr 2016 08:54

Last Modified:

06 Apr 2016 08:54

Publisher DOI:


PubMed ID:



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