SYSTEMATIC REVIEW article
Front. Cardiovasc. Med.
Sec. Thrombosis and Haemostasis
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1496334
Antithrombotic strategies after transcatheter aortic valve replacement a network Meta-analysis
Provisionally accepted
- 1Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Number 321 Zhong-shan Road, Nanjing 210008, Jiangsu, China., Nanjing, China
- 2Nanjing Drum Tower Hospital, Nanjing, Jiangsu Province, China
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The optimal antithrombotic regimen for patients without an indication for oral anticoagulation (OAC) after transcatheter aortic valve replacement (TAVR) remains unclear.We conducted a network meta-analysis of randomized controlled trials to clarify the best postoperative antithrombotic regimen. We searched literature databases including PubMed/Medline and Cochrane up to June 2024. Safety endpoints included all-cause death, cardiovascular death, major/life-threatening bleeding, and minor bleeding during follow-up. Efficacy endpoints encompassed ischaemic stroke/ transient ischemic attack (TIA), systemic embolism, hypoattenuated leaflet thickening (HALT), and reduced leaflet motion (RELM). Outcomes were assessed during the follow-up period specified in each trial(range:3-24months). The results were statistically analyzed using R 4.3.2 and Stata 16 software. The final analysis included seven randomized controlled trials. Single antiplatelet therapy (SAPT) showed a lower incidence of major/life-threatening bleeding compared to the direct oral anticoagulants (DOACs) group (OR: 0.68, 95% CI: 0.47-0.99, P = 0.002) during the 3-24month post-TAVR period. However, no significant differences were found in other safety or efficacy endpoints. SAPT is the preferred treatment strategy for TAVR patients without anticoagulation indications.
Keywords: TAVR, antithrombotic therapy, antiplatelet therapy, Anticoagulation therapy, Meta-analysis
Received: 14 Sep 2024; Accepted: 24 Apr 2025.
Copyright: © 2025 Shi, Wu and Qing. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhou Qing, Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Number 321 Zhong-shan Road, Nanjing 210008, Jiangsu, China., Nanjing, China
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