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Data on optimal antithrombotic therapy after t-TEER in patients with an indication for anticoagulation are scarce and evidence-based guideline recommendations are lacking. We sought to investigate efficacy and safety of novel oral anticoagulation (NOAC) and vitamin-K-antagonists (VKA) in patients undergoing t-TEER.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Among 78 consecutive patients with t-TEER of severe TR, 69 patients were identified with concomitant indication for oral anticoagulation. Outcomes of these patients treated with NOAC or VKA were compared over a median follow-up period of 327 (177\u2013460) days.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Despite elevated thromboembolic and bleeding risk scores (CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc 4.2 \u00b1 1.1, HEMORR<jats:sub>2<\/jats:sub>HAGES 3.0 \u00b1 1.0 and HAS-BLED 2.1 \u00b1 0.8), only one major bleeding incidence occurred under NOAC therapy. The risk for overall (NOAC 8% vs. VKA group 26%, <jats:italic>p = <\/jats:italic>0.044) and major bleeding events (NOAC 2% vs. VKA 21%, <jats:italic>p = <\/jats:italic>0.010) was significantly lower in the NOAC compared to the VKA group. No significant difference was found between NOAC and VKA treatment in terms of mortality (NOAC 18% vs. VKA 16%, <jats:italic>p = <\/jats:italic>0.865) or the combined endpoint of death, heart failure hospitalization, stroke, embolism, thrombosis, myocardial infarction, and severe bleeding (NOAC 48% vs. VKA 42%, <jats:italic>p = <\/jats:italic>0.801). A comparison between apixaban (<jats:italic>n = <\/jats:italic>27) and rivaroxaban (<jats:italic>n = <\/jats:italic>16) treated patients revealed no significant differences between NOAC substances (all bleeding events apixaban 7% vs. rivaroxaban 13%, <jats:italic>p = <\/jats:italic>0.638).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Results of this study indicate that NOACs may offer a favorable risk\u2013benefit profile for patients with concomitant indication for anticoagulation therapy following t-TEER.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s00392-024-02517-z","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T12:02:42Z","timestamp":1724068962000},"page":"846-855","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Favorable safety profile of NOAC therapy in patients after tricuspid transcatheter edge-to-edge repair"],"prefix":"10.1007","volume":"114","author":[{"given":"Isabel A.","family":"Hoerbrand","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin J.","family":"Kraus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Gruber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas A.","family":"Geis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Schlegel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Frey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9852-1039","authenticated-orcid":false,"given":"Mathias H.","family":"Konstandin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,8,19]]},"reference":[{"key":"2517_CR1","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1093\/eurheartj\/ehv487","volume":"38","author":"M Arsalan","year":"2017","unstructured":"Arsalan M, Walther T, Smith RL, Grayburn PA (2017) Tricuspid regurgitation diagnosis and treatment. 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