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Clinical Research in Cardiology

Published in:

01-09-2018 | Original Paper

NOAC monotherapy in patients with concomitant indications for oral anticoagulation undergoing transcatheter aortic valve implantation

Authors: Nicolas A. Geis, Christina Kiriakou, Emmanuel Chorianopoulos, Lorenz Uhlmann, Hugo A. Katus, Raffi Bekeredjian

Published in: Clinical Research in Cardiology | Issue 9/2018

Abstract

Aims

Antithrombotic therapy after transcatheter aortic valve implantation (TAVI) is highly controversial and guideline recommendations are not evidence based. We assessed efficacy and safety of non-vitamin K antagonist oral anticoagulant (NOAC) monotherapy in patients with concomitant indications for OAC undergoing TAVI.

Methods

Among more than 1300 TAVI patients since 2008, 154 patients were identified who received postinterventional NOAC monotherapy. Outcomes were compared to 172 patients treated with vitamin K antagonist (VKA) monotherapy. Thromboembolic as well as bleeding complications were analysed for 6 months after TAVI.

Results

Despite high CHA₂DS₂-Vasc (4.6 ± 1.2), HEMORR₂HAGES (4.7 ± 1.9) and HASBLED (2.7 ± 0.8) scores only three major/life-threatening bleedings and four thromboembolic events occurred after NOAC therapy had been initiated post-TAVI. 12 patients (7.8%) died within 6 months after the procedure. Compared to patients being treated with VKA monotherapy, analysis of a combined end-point of post-procedural death, stroke, embolism and severe bleeding revealed no significant differences (17/154 vs. 14/172; p = 0.45).

Conclusions

The results of this study suggest that NOAC therapy without additional antiplatelet treatment is effective and safe in patients with concomitant indications for OAC undergoing TAVI.

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Title: NOAC monotherapy in patients with concomitant indications for oral anticoagulation undergoing transcatheter aortic valve implantation
Authors: Nicolas A. Geis
Christina Kiriakou
Emmanuel Chorianopoulos
Lorenz Uhlmann
Hugo A. Katus
Raffi Bekeredjian
Publication date: 01-09-2018
Publisher: Springer Berlin Heidelberg
Published in: Clinical Research in Cardiology / Issue 9/2018
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-018-1247-x

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