{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:18:35Z","timestamp":1786706315693,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T00:00:00Z","timestamp":1666137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["397484323\u2010TRR259"],"award-info":[{"award-number":["397484323\u2010TRR259"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite major advances, transcatheter aortic valve replacement (TAVR) is still associated with procedure\u2010specific complications. Although previous studies reported lower bleeding rates in patients receiving protamine for heparin reversal, the optimal protamine\u2010to\u2010heparin dosing ratio is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>The aim of this study was a comparison of two different heparin antagonization regimens for the prevention of bleeding complications after TAVR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study included 1446 patients undergoing TAVR, of whom 623 received partial and 823 full heparin antagonization. The primary endpoint was a composite of 30\u2010day mortality, life\u2010threatening, and major bleeding. Safety endpoints included stroke and myocardial infarction at 30 days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Full antagonization of heparin resulted in lower rates of the primary endpoint as compared to partial heparin reversal (5.6% vs. 10.4%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01), which was mainly driven by lower rates of life\u2010threatening (0.5% vs. 1.6%, <jats:italic>p<\/jats:italic>\u2009=\u2009.05) and major bleeding (3.2% vs. 7.5%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). Moreover, the incidence of major vascular complications was significantly lower in patients with full heparin reversal (3.5% vs. 7.5%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). The need for red\u2010blood\u2010cell transfusion was lower in patients receiving full as compared to partial heparin antagonization (10.4% vs. 15.9%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). No differences were observed in the incidence of stroke and myocardial infarction between patients with full and partial heparin reversal (2.2% vs. 2.6%, <jats:italic>p<\/jats:italic>\u2009=\u2009.73 and 0.2% vs. 0.4%, <jats:italic>p<\/jats:italic>\u2009=\u2009.64, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Full heparin antagonization resulted in significantly lower rates of life\u2010threatening and major bleeding after TAVR as compared to partial heparin reversal. The occurrence of stroke and myocardial infarction was low and comparable between both groups.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23936","type":"journal-article","created":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T12:56:31Z","timestamp":1666184191000},"page":"67-75","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Optimal protamine\u2010to\u2010heparin dosing ratio for the prevention of bleeding complications in patients undergoing TAVR\u2014A multicenter experience"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2967-6613","authenticated-orcid":false,"given":"Baravan","family":"Al\u2010Kassou","sequence":"first","affiliation":[{"name":"Department of Medicine II Heart Center, University Hospital Bonn  Bonn 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