RT Journal Article
T1 Impact of anticoagulation therapy on valve haemodynamic deterioration following transcatheter aortic valve replacement.
A1 Del Trigo, María
A1 Muñoz-García, Antonio J
A1 Latib, Azeem
A1 Auffret, Vincent
A1 Wijeysundera, Harindra C
A1 Nombela-Franco, Luis
A1 Gutierrez, Enrique
A1 Cheema, Asim N
A1 Serra, Vicenç
A1 Amat-Santos, Ignacio J
A1 Kefer, Joelle
A1 Benitez, Luis Miguel
A1 Leclercq, Florence
A1 Mangieri, Antonio
A1 Le Breton, Hervé
A1 Jiménez-Quevedo, Pilar
A1 Garcia Del Blanco, Bruno
A1 Dager, Antonio
A1 Abdul-Jawad Altisent, Omar
A1 Puri, Rishi
A1 Pibarot, Philippe
A1 Rodés-Cabau, Josep
K1 aortic stenosis
K1 transcatheter valve interventions
AB To evaluate the changes in transvalvular gradients and the incidence of valve haemodynamic deterioration (VHD) following transcatheter aortic valve replacement (TAVR), according to use of anticoagulation therapy. This multicentre study included 2466 patients (46% men; mean age 81±7 years) who underwent TAVR with echocardiography performed at 12-month follow-up. Anticoagulation therapy was used in 707 patients (28.7%) following TAVR (AC group). A total of 663 patients received vitamin K antagonists, and 44 patients received direct oral anticoagulants. A propensity score matching analysis was performed to adjust for intergroup (AC vs non-AC post-TAVR) differences. A total of 622 patients per group were included in the propensity-matched analysis. VHD was defined as a ≥10 mm Hg increase in the mean transprosthetic gradient at follow-up (vs hospital discharge). The mean clinical follow-up was 29±18 months. The mean transvalvular gradient significantly increased at follow-up in the non-AC group within the global cohort (P=0.003), whereas it remained stable over time in the AC group (P=0.323). The incidence of VHD was significantly lower in the AC group (0.6%) compared with the non-AC group (3.7%, P The lack of anticoagulation therapy post-TAVR was associated with significant increments in transvalvular gradients and a greater risk of VHD. VHD was subclinical in most cases and did not associate with major adverse clinical events. Future randomised trials are needed to determine if systematic anticoagulation therapy post-TAVR would reduce the incidence of VHD.
YR 2018
FD 2018-02-13
LK http://hdl.handle.net/10668/12129
UL http://hdl.handle.net/10668/12129
LA en
DS RISalud
RD Apr 6, 2025