TAVR: nemesis of NOACs?
Bleeding
NOAC
TAVR
Journal
Journal of thrombosis and thrombolysis
ISSN: 1573-742X
Titre abrégé: J Thromb Thrombolysis
Pays: Netherlands
ID NLM: 9502018
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
accepted:
13
10
2022
pubmed:
2
11
2022
medline:
16
2
2023
entrez:
1
11
2022
Statut:
ppublish
Résumé
Data on non-vitamin K antagonist oral anticoagulants (NOACs) in transcatheter aortic valve replacement (TAVR) patients are controversial. In patients without atrial fibrillation (AF), rivaroxaban showed enhanced ischemia and bleeding as compared to standard of care. ENVISAGE showed enhanced bleeding in AF patients as compared to vitamin K antagonist (VKA). Only apixaban was non-inferior but failed superiority regarding bleeding in AF patients after TAVR. One could hypothesize that this might be due to pharmacokinetics of NOACs. Therefore, we compared outcome in rivaroxaban/edoxaban (once-daily) and apixaban (twice-daily) treated patients. 568 patients with indication for permanent oral anticoagulation due to AF undergoing TAVR were analyzed via inverse probability of treatment weighting. Valve academic research consortium complications during 30-day follow-up were assessed. Bleeding complications were similar in once-daily and twice-daily NOACs (major: 22 (7.5%) vs. 14 (5.3%), p = 0.285; minor: 66 (22.4%) vs. 46 (17.4%), p = 0.133). Complications did not change when splitting the cohort in the different agents apixaban, rivaroxaban and edoxaban. These findings remained robust after multivariate analysis. In summary, twice-daily and once-daily NOACs did not differ regarding bleeding complications in a hypothesis generating real-world cohort of TAVR patients with AF.
Identifiants
pubmed: 36318378
doi: 10.1007/s11239-022-02721-6
pii: 10.1007/s11239-022-02721-6
pmc: PMC9925602
doi:
Substances chimiques
Anticoagulants
0
edoxaban
NDU3J18APO
Rivaroxaban
9NDF7JZ4M3
Fibrinolytic Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
181-184Subventions
Organisme : Forschungskommission of the Medical Faculty of the Heinrich Heine University Duesseldorf
ID : 18-2019
Organisme : Forschungskommission of the Medical Faculty of the Heinrich Heine University Duesseldorf
ID : 51-2020
Organisme : German Research Foundation
ID : PO 2247/2-1
Organisme : German Research Foundation
ID : SFB1116
Informations de copyright
© 2022. The Author(s).
Références
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