Dual or Single Antiplatelet Therapy After Transcatheter Aortic Valve Implantation? A Systematic Review and Meta-Analysis

Publisher： Bentham Science Publishers

E-ISSN： 1873-4286|22|29|4596-4603

ISSN： 1381-6128

Source： Current Pharmaceutical Design, Vol.22, Iss.29, 2016-09, pp. : 4596-4603

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Abstract

Background: Transcatheter aortic valve implantation (TAVI) has undeniablyearned a prestigious post in the quiver of interventional cardiologists against symptomaticsevere aortic stenosis. Cerebrovascular events are listed within the most frequent complications.Methods: We performed a systematic search of EMBASE, MEDLINE, and the Cochranelibrary from inception to March 2016 for the following search terms (transcatheter ANDantiplatelet) OR (transcatheter AND antithrombotic) to retrieve studies of dual antiplatelettreatment (DAPT) and single antiplatelet treatment (SAPT) in patients after TAVI to studythrombotic, hemorrhagic and cardiovascular events at 30 days post procedure. From a totalof 208 records 4 studies met inclusion criteria.Results: In the included studies, 286 patients were enrolled in the DAPT group and 354patients in the SAPT group. There was no difference in all-cause mortality, cardiovascular mortality, stroke, andmyocardial infraction 30 days post TAVI between DAPT and SAPT. However, patients in the DAPT group had asignificantly increased incidence of lethal and major bleeding at 30 days of follow-up and the incidence of thecombined end-point of stroke, spontaneous MI, all-cause mortality and major bleeding was significantly higher inthe DAPT group in comparison to the SAPT group.Conclusion: DAPT compared to SAPT in patients after TAVI increases incidence of hemorrhagic events with nobenefits in terms of thrombotic events and cardiovascular mortality. However, these data must be interpretedcautiously and the choice of DAPT over SAPT must be based on an individual patient characteristic according tomedical practice criteria.