Author + information
- Ron Waksman,
- M. Chadi Alraies,
- Kyle Buchanan,
- Edward Koifman,
- Homam Moussa Pacha,
- Arie Steinvil,
- Toby Rogers,
- Jiaxiang Gai,
- Rebecca Torguson,
- Michael Gaglia,
- Itsik Ben-Dor,
- Augusto Pichard and
- Lowell Satler
Background: Oral anticoagulation (OAC) prescribing patterns for atrial fibrillation (AF) patients vary following transcatheter aortic valve replacement (TAVR). However, there are limited data on the ideal antithrombotic treatment strategy and outcomes in the U.S.
Methods: We evaluated AF patients on OAC who underwent TAVR from 2007 to 2016. Clinical outcomes were assessed at 30-day and 1-year follow-up.
Results: A total of 305 AF patients (mean age 83 years, 64% men) were analyzed. Overall, 54% (n=163) were discharged on single OAC + single antiplatelet therapy, 33% (102) on dual antiplatelet therapy (DAPT) and 13% (40) on warfarin + DAPT (triple therapy). All three groups were similar with respect to age (p=0.1), hypertension (p=0.19), diabetes (p=0.3), stroke (p=0.36), congestive heart failure (p=0.16), coronary artery disease (p=0.14), and peripheral artery disease (p=0.37). Women were more likely than men to receive triple therapy. There was no difference in rates of stroke (p=0.43), renal failure (p=0.19), major vascular complication (p=0.52) and life-threatening (p=0.25) or major bleeding (p=0.83) between the three groups. However, unadjusted 30-day and 1-year mortality rates were higher in the triple therapy group (Logrank p=0.0149, and 0.0465, respectively) compared with those of the other groups (Figure).
Conclusions: AF patients treated with triple therapy post-TAVR have higher rates of death and bleeding compared with those not treated with triple therapy
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Interventional Cardiology: TAVR 3
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1243-188
- 2017 American College of Cardiology Foundation