title: Variability in Antithrombotic Therapy Regimens Peri-TAVR: A Single Academic Center Experience.
abstract: BACKGROUND
  The aim of this study was to describe peri-procedural antithrombotic use in patients undergoing transcatheter aortic valve replacement (TAVR) at a single academic medical center.
  
  
  METHODS
  Retrospective collection of antiplatelet and anticoagulant use during the index hospitalization for all patients undergoing TAVR at our institution from April 2009 through March 2014.
  
  
  RESULTS
  Of a total of 255 patients undergoing the procedure, 132 (51%) had an indication for anticoagulation pre-TAVR and 92 (70% of those with an indication) were on treatment. On discharge, 106 patients (44% of total surviving to discharge, 73% of those surviving with an indication for anticoagulation) were treated with oral anticoagulation. Of these patients, 89 (84%) were discharged on aspirin and an oral anticoagulant without clopidogrel. Only 122 (51% of total patients) were discharged on the regimen of aspirin and clopidogrel alone.
  
  
  CONCLUSIONS
  Peri-procedural antithrombotic regimens vary greatly following TAVR. More than half of patients have an indication for anticoagulation following the procedure. Most patients at our institution who require anticoagulation are discharged on aspirin and an oral anticoagulant, though the optimal regimen requires further investigation.
authors.affiliation: Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA. jerossi27@gmail.com.
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Rossi
authors.affiliation: Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Noll
authors.affiliation: Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Bergmark
authors.affiliation: Division of Cardiology, University of Washington, Seattle, WA, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: McCabe
authors.affiliation: Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Nemer
authors.affiliation: Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Okada
authors.affiliation: Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Anant
authors.initials: A
authors.lastname: Vasudevan
authors.affiliation: Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Davidson
authors.affiliation: Division of Cardiovascular Medicine, University of Utah, Salt Lake City, UT, USA.
authors.forename: Frederick
authors.initials: F
authors.lastname: Welt
authors.affiliation: Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Eisenhauer
authors.affiliation: Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Pinak
authors.initials: P
authors.lastname: Shah
authors.affiliation: Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Giugliano
keywords: Anticoagulation; Antithrombotic therapy; Atrial fibrillation; Dual antiplatelet therapy (DAPT); Stroke; Structural heart disease; Transcatheter aortic valve replacement (TAVR); Transfemoral aortic valve implantation (TAVI); Triple therapy