Aspirin with or without clopidogrel after transcatheter aortic-valve implantation


  • Heather Mason
  • Univadis Medical News
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A study conducted in patients who were undergoing transcatheter aortic-valve implantation (TAVI) showed that aspirin alone was associated with a lower incidence of bleeding among patients who did not have indications for long-term use of oral anticoagulation, according to an article published in the New England Journal of Medicine.

Patients undergoing TAVI (n=665) were randomised to aspirin monotherapy (n=331) or aspirin plus clopidogrel (n=334) during a three month period. The two primary outcomes were all bleeding and non-procedure-related bleeding over a period of 12 months. The two secondary outcomes were a composite of death from cardiovascular causes, non-procedure-related bleeding, stroke, or myocardial infarction, and a composite of death from cardiovascular causes, ischaemic stroke, or myocardial infarction at one year.

The results show that a bleeding event occurred in 15.1 per cent of patients receiving aspirin alone and in 26.6 per cent receiving aspirin plus clopidogrel. Non-procedure-related bleeding occurred in 50 patients and 83 patients, respectively.

These findings, along with the analysis of the secondary outcomes, revealed that aspirin alone was noninferior to combined therapy, but it was not superior to aspirin plus clopidogrel for the composite of thromboembolic events among patients undergoing TAVI who did not have an indication for oral anticoagulation.