Oral anticoagulation with apixaban after TAVR not superior to the standard of care: Study
France: In a new study conducted by Jean-Philippe Collet and the team, it was shown that Apixaban was not superior to the standard of care after transcatheter aortic valve implantation (TAVI), regardless of the rationale for oral anticoagulation. The findings of this study were published in European Heart Journal.
The roles of oral anticoagulation and antiplatelet treatment after transcatheter aortic valve implantation (TAVI) are still being disputed. ATLANTIS is a randomized, open-label, worldwide study that compares apixaban to the standard of treatment.
Following successful TAVI, 1500 patients were randomly assigned (1:1) to receive apixaban 5 mg twice a day (n = 749) or standard of care (n = 751). The necessity for persistent anticoagulant treatment was used to stratify the randomization. Patients on standard-of-care got a vitamin K antagonist (VKA) (Stratum 1) or antiplatelet treatment (Stratum 2) depending on whether anticoagulation was indicated or not. Over a one-year period of follow-up, the primary endpoint was a composite of death, stroke or transient ischaemic attack, deep vein thrombosis or pulmonary embolism, myocardial infarction, systemic embolism, intracardiac, or bioprosthesis thrombosis, and life-threatening, disabling, or major bleeding. Major, debilitating, or life-threatening bleeding was the key safety objective.
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