RT Journal Article
T1 Assessment of Platelet REACtivity After Transcatheter Aortic Valve Replacement: The REAC-TAVI Trial.
A1 Jimenez Diaz, Victor Alfonso
A1 Tello-Montoliu, Antonio
A1 Moreno, Raul
A1 Cruz Gonzalez, Ignacio
A1 Baz Alonso, Jose Antonio
A1 Romaguera, Rafael
A1 Molina Navarro, Eduardo
A1 Juan Salvadores, Pablo
A1 Paredes Galan, Emilio
A1 De Miguel Castro, Antonio
A1 Bastos Fernandez, Guillermo
A1 Ortiz Saez, Alberto
A1 Fernandez Barbeira, Saleta
A1 Raposeiras Roubin, Sergio
A1 Ocampo Miguez, Juan
A1 Serra Peñaranda, Antonio
A1 Valdes Chavarri, Mariano
A1 Cequier Fillat, Angel
A1 Calvo Iglesias, Francisco
A1 Iñiguez Romo, Andres
K1 VerifyNow
K1 antithrombotic therapy
K1 aortic stenosis
K1 high platelet reactivity
K1 transcatheter aortic valve replacement
AB The REAC-TAVI (Assessment of platelet REACtivity after Transcatheter Aortic Valve Implantation) trial enrolled patients with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) pre-treated with aspirin + clopidogrel, aimed to compare the efficacy of clopidogrel and ticagrelor in suppressing high platelet reactivity (HPR) after TAVI. Current recommendations support short-term use of aspirin + clopidogrel for patients with severe AS undergoing TAVR despite the lack of compelling evidence. This was a prospective, randomized, multicenter investigation. Platelet reactivity was measured at 6 different time points with the VerifyNow assay (Accriva Diagnostics, San Diego, California). HPR was defined as (P2Y12 reaction units (PRU) ≥208. Patients with HPR before TAVR were randomized to either aspirin + ticagrelor or aspirin + clopidogrel for 3 months. Patients without HPR continued with aspirin + clopidogrel (registry cohort). The primary endpoint was non-HPR status (PRU  A total of 68 patients were included. Of these, 48 (71%) had HPR (PRU 273 ± 09) and were randomized to aspirin + ticagrelor (n = 24, PRU 277 ± 08) or continued with aspirin + clopidogrel (n = 24, PRU 269 ± 49). The remaining 20 patients (29%) without HPR (PRU 133 ± 12) were included in the registry. Overall, platelet reactivity across all the study time points after TAVR was lower in patients randomized to ticagrelor compared with those treated with clopidogrel, including those enrolled in the registry (p  HPR to clopidogrel is present in a considerable number of patients with AS undergoing TAVR. Ticagrelor achieves a better and faster effect, providing sustained suppression of HPR to these patients. (Platelet Reactivity After TAVI: A Multicenter Pilot Study [REAC-TAVI]; NCT02224066).
YR 2019
FD 2019
LK http://hdl.handle.net/10668/13393
UL http://hdl.handle.net/10668/13393
LA en
DS RISalud
RD Apr 11, 2025