title: Antiplatelet Therapy in TAVI: Current Clinical Practice and Recommendations.
abstract: Transcatheter aortic valve implantation (TAVI) is all the more used therapeutic option for patients suffering from symptomatic severe aortic valvular stenosis declined by surgeons because of high surgical risk. Given the high bleeding and ischemic risk of this vulnerable population, their antithrombotic treatment becomes a crucial issue. There is no consensus on antithrombotic treatment after TAVI and dual antiplatelet therapy (DAPT) with aspirin (indefinitely) and clopidogrel (1-6 months) is, in general, recommended. With regards to patients with an indication for oral anticoagulation (OAC), a combination of OAC plus aspirin or clopidogrel is commonly suggested. This review underscores that it is extremely difficult to compare different antithrombotic regimens in patients undergoing TAVI because of their variable demographic characteristics. Nevertheless, available data suggest that DAPT results to more bleeding events. Still, whether it positively affects ischemic episodes is doubtful. Ongoing trials are expected to draw a clearer picture on the field.
authors.affiliation: 133, Avenue de la Résistance, 92350 Le Plessis-Robinson, France. nmagoutis@yahoo.com.
authors.forename: Nikolaos A
authors.initials: NA
authors.lastname: Magkoutis
authors.forename: Sabi
authors.initials: S
authors.lastname: Fradi
authors.forename: Alexandre
authors.initials: A
authors.lastname: Azmoun
authors.forename: Ramsi
authors.initials: R
authors.lastname: Ramadan
authors.forename: Sami
authors.initials: S
authors.lastname: Ben Ouanes
authors.forename: Manolis
authors.initials: M
authors.lastname: Vavuranakis
authors.forename: Dimitrios A
authors.initials: DA
authors.lastname: Vrachatis
authors.forename: Theodore G
authors.initials: TG
authors.lastname: Papaioannou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tousoulis
authors.forename: Saïd
authors.initials: S
authors.lastname: Ghostine
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D004359:Drug Therapy, Combination; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects* / Q000379:methods*
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin