{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:52:46Z","timestamp":1789141966971,"version":"build-2803163510"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001791","name":"Griffith University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001791","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Drugs Ther"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Valve-in-valve transcatheter aortic valve implantation is a less invasive alternative to redo surgery for failed surgical bioprostheses, but optimal antithrombotic management is uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare outcomes across antithrombotic regimens after valve-in-valve procedures in real-world practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In the Australasian Cardiac Outcomes Registry (2018\u20132025), 1,050 adults were grouped by discharge regimen: single antiplatelet therapy, dual antiplatelet therapy, oral anticoagulation, or oral anticoagulation plus antiplatelet therapy. Outcomes included 30-day and 12-month mortality, stroke\/TIA, life-threatening or major bleeding, major adverse cardiac and cerebrovascular events, and echocardiographic valve performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-day mortality was higher with oral anticoagulation (1.7%) and combination therapy (3.6%) than with single or dual antiplatelet therapy (both 0%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The 30-day MACCE rate was greater with oral anticoagulation (4.5%) and combination therapy (4.4%) than with single (1.5%) or dual antiplatelet therapy (0.4%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003); stroke\/TIA and bleeding were infrequent and similar across groups. At 12 months, MACCE remained highest with oral anticoagulation (11.8%) and combination therapy (10.7%) compared with single (5.0%) and dual antiplatelet therapy (3.2%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Mortality at 12 months was numerically higher with oral anticoagulation or combination therapy (5.2% and 4.4%) than with single or dual antiplatelet therapy (1.8% and 2.4%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.116). At 30 days, transvalvular gradients were lower in patients receiving oral anticoagulation-containing regimens; however, no significant differences in gradients, valve area, ejection fraction, or regurgitation were observed at 12 months. In multivariable analysis, combination therapy was independently associated with higher odds of 12-month MACCE compared with SAPT (OR 2.76, 95% CI 1.03\u20137.37;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043). Higher STS score and greater frailty were also independently associated with 12-month MACCE.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this observational cohort of patients undergoing valve-in-valve TAVI, oral anticoagulation-containing regimens were associated with higher early mortality and higher 12-month MACCE rates than antiplatelet-only strategies. However, these associations should be interpreted cautiously, as they likely reflect in part the greater baseline comorbidity burden of patients prescribed anticoagulation rather than a direct treatment effect. No sustained haemodynamic benefit was observed at 12 months. Individualised antithrombotic therapy and prospective randomised studies are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10557-026-07914-2","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T01:32:53Z","timestamp":1784251973000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparative Analysis of Antithrombotic Strategies Following Valve-in-Valve Transcatheter Aortic Valve Implantation Using Real-World Registry Data"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8947-2963","authenticated-orcid":false,"given":"Edward","family":"Dababneh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Gabriela","family":"Matta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Sinhal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selvanayagam","family":"Niranjan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvio","family":"Provenzano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Camuglia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Hughes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuljit","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"7914_CR1","doi-asserted-by":"publisher","first-page":"e006730","DOI":"10.1161\/CIRCINTERVENTIONS.118.006730","volume":"11","author":"M Abdel-Wahab","year":"2018","unstructured":"Abdel-Wahab M, Simonato M, Latib A, Goleski PJ, Allali A, Kaur J, et al. Clinical Valve Thrombosis After Transcatheter Aortic Valve-in-Valve Implantation. Circulation: Cardiovasc Interventions. 2018;11:e006730. https:\/\/doi.org\/10.1161\/CIRCINTERVENTIONS.118.006730.","journal-title":"Circulation: Cardiovasc Interventions"},{"key":"7914_CR2","doi-asserted-by":"publisher","first-page":"709","DOI":"10.4244\/eij-d-21-00157","volume":"17","author":"G Tarantini","year":"2021","unstructured":"Tarantini G, Dvir D, Tang GHL. Transcatheter aortic valve implantation in degenerated surgical aortic valves. EuroIntervention. 2021;17:709\u201319. https:\/\/doi.org\/10.4244\/eij-d-21-00157.","journal-title":"EuroIntervention"},{"key":"7914_CR3","doi-asserted-by":"publisher","first-page":"505","DOI":"10.21037\/acs.2020.04.04","volume":"9","author":"KL Sibilitz","year":"2020","unstructured":"Sibilitz KL, Fukutomi M, Sondergaard L. Valve thrombosis after transcatheter aortic valve replacement-cause for concern? Ann Cardiothorac Surg. 2020;9:505\u20137. https:\/\/doi.org\/10.21037\/acs.2020.04.04.","journal-title":"Ann Cardiothorac Surg"},{"key":"7914_CR4","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.1016\/j.jacc.2020.12.052","volume":"77","author":"MB Leon","year":"2021","unstructured":"Leon MB, Mack MJ, Hahn RT, Thourani VH, Makkar R, Kodali SK, et al. Outcomes 2 Years After Transcatheter Aortic Valve Replacement in Patients at Low Surgical Risk. J Am Coll Cardiol. 2021;77:1149\u201361. https:\/\/doi.org\/10.1016\/j.jacc.2020.12.052.","journal-title":"J Am Coll Cardiol"},{"key":"7914_CR5","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1016\/j.jcin.2017.01.045","volume":"10","author":"J Jose","year":"2017","unstructured":"Jose J, Sulimov DS, El-Mawardy M, Sato T, Allali A, Holy EW, et al. Clinical Bioprosthetic Heart Valve Thrombosis After Transcatheter Aortic Valve Replacement: Incidence, Characteristics, and Treatment Outcomes. JACC Cardiovasc Interv. 2017;10:686\u201397. https:\/\/doi.org\/10.1016\/j.jcin.2017.01.045.","journal-title":"JACC Cardiovasc Interv"},{"key":"7914_CR6","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.jcin.2018.09.040","volume":"12","author":"MA Cavender","year":"2019","unstructured":"Cavender MA, Kim SM. Utility of Dual Antiplatelet Therapy for the Prevention of Subclinical Leaflet Thrombosis: Now Is Not the Time to HALT the Use of Dual Antiplatelet Therapy. JACC Cardiovasc Interv. 2019;12:19\u201321. https:\/\/doi.org\/10.1016\/j.jcin.2018.09.040.","journal-title":"JACC Cardiovasc Interv"},{"key":"7914_CR7","doi-asserted-by":"publisher","first-page":"e007411","DOI":"10.1161\/circinterventions.118.007411","volume":"12","author":"P Guedeney","year":"2019","unstructured":"Guedeney P, Mehran R, Collet JP, Claessen BE, Ten Berg J, Dangas GD. Antithrombotic Therapy After Transcatheter Aortic Valve Replacement. Circ Cardiovasc Interv. 2019;12:e007411. https:\/\/doi.org\/10.1161\/circinterventions.118.007411.","journal-title":"Circ Cardiovasc Interv"},{"key":"7914_CR8","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1016\/j.jcin.2022.02.014","volume":"15","author":"RT Hahn","year":"2022","unstructured":"Hahn RT, Webb J, Pibarot P, Ternacle J, Herrmann HC, Suri RM, et al. 5-Year Follow-Up From the PARTNER 2 Aortic Valve-in-Valve Registry for Degenerated Aortic Surgical Bioprostheses. JACC Cardiovasc Interv. 2022;15:698\u2013708. https:\/\/doi.org\/10.1016\/j.jcin.2022.02.014.","journal-title":"JACC Cardiovasc Interv"},{"key":"7914_CR9","doi-asserted-by":"publisher","first-page":"2783","DOI":"10.1093\/eurheartj\/ehac242","volume":"43","author":"JP Collet","year":"2022","unstructured":"Collet JP, Van Belle E, Thiele H, Berti S, Lhermusier T, Manigold T, et al. Apixaban vs. standard of care after transcatheter aortic valve implantation: the ATLANTIS trial. Eur Heart J. 2022;43:2783\u201397. https:\/\/doi.org\/10.1093\/eurheartj\/ehac242.","journal-title":"Eur Heart J"},{"key":"7914_CR10","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1056\/NEJMoa1911425","volume":"382","author":"GD Dangas","year":"2020","unstructured":"Dangas GD, Tijssen JGP, W\u00f6hrle J, S\u00f8ndergaard L, Gilard M, M\u00f6llmann H, et al. A Controlled Trial of Rivaroxaban after Transcatheter Aortic-Valve Replacement. N Engl J Med. 2020;382:120\u20139. https:\/\/doi.org\/10.1056\/NEJMoa1911425.","journal-title":"N Engl J Med"},{"key":"7914_CR11","doi-asserted-by":"crossref","unstructured":"Jimenez Diaz Victor A, Guerreiro C. Dual vs single antiplatelet therapy after valve-in-valve TAVR. JACC Cardiovasc Interv. 2025;18:2740\u20132743.","DOI":"10.1016\/j.jcin.2025.10.012"},{"key":"7914_CR12","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1016\/j.hlc.2025.02.107","volume":"34","author":"A Sinhal","year":"2025","unstructured":"Sinhal A, Bennetts J, Bhindi R, Cashman K, Deakin A, Gooley R, et al. Australian Cardiac Outcomes Registry of Transcatheter Aortic Valve Implantation: Report and Update of Transcatheter Aortic Valve Implantation in Australia. Heart Lung Circulation. 2025;34:472\u201384. https:\/\/doi.org\/10.1016\/j.hlc.2025.02.107.","journal-title":"Heart Lung Circulation"},{"key":"7914_CR13","doi-asserted-by":"publisher","first-page":"2717","DOI":"10.1016\/j.jacc.2021.02.038","volume":"77","author":"P G\u00e9n\u00e9reux","year":"2021","unstructured":"G\u00e9n\u00e9reux P, Piazza N, Alu MC, Nazif T, Hahn RT, Pibarot P, et al. Valve Academic Research Consortium 3: Updated Endpoint Definitions for Aortic Valve Clinical Research. J Am Coll Cardiol. 2021;77:2717\u201346. https:\/\/doi.org\/10.1016\/j.jacc.2021.02.038.","journal-title":"J Am Coll Cardiol"},{"key":"7914_CR14","doi-asserted-by":"publisher","first-page":"1731","DOI":"10.3390\/diagnostics13101731","volume":"13","author":"D Angellotti","year":"2023","unstructured":"Angellotti D, Manzo R, Castiello DS, et al. Hemodynamic Performance of Transcatheter Aortic Valves: A Comprehensive Review. Diagnostics. 2023;13:1731.","journal-title":"Diagnostics"},{"key":"7914_CR15","doi-asserted-by":"publisher","first-page":"2383","DOI":"10.1016\/s0140-6736(17)30757-2","volume":"389","author":"T Chakravarty","year":"2017","unstructured":"Chakravarty T, S\u00f8ndergaard L, Friedman J, De Backer O, Berman D, Kofoed KF, et al. Subclinical leaflet thrombosis in surgical and transcatheter bioprosthetic aortic valves: an observational study. Lancet. 2017;389:2383\u201392. https:\/\/doi.org\/10.1016\/s0140-6736(17)30757-2.","journal-title":"Lancet"},{"key":"7914_CR16","doi-asserted-by":"publisher","first-page":"2201","DOI":"10.1093\/eurheartj\/ehx369","volume":"38","author":"L Sondergaard","year":"2017","unstructured":"Sondergaard L, De Backer O, Kofoed KF, Jilaihawi H, Fuchs A, Chakravarty T, et al. Natural history of subclinical leaflet thrombosis affecting motion in bioprosthetic aortic valves. Eur Heart J. 2017;38:2201\u20137. https:\/\/doi.org\/10.1093\/eurheartj\/ehx369.","journal-title":"Eur Heart J"},{"key":"7914_CR17","doi-asserted-by":"publisher","first-page":"e011480","DOI":"10.1161\/circinterventions.121.011480","volume":"15","author":"S Garcia","year":"2022","unstructured":"Garcia S, Fukui M, Dworak MW, Okeson BK, Garberich R, Hashimoto G, et al. Clinical Impact of Hypoattenuating Leaflet Thickening After Transcatheter Aortic Valve Replacement. Circ Cardiovasc Interv. 2022;15:e011480. https:\/\/doi.org\/10.1161\/circinterventions.121.011480.","journal-title":"Circ Cardiovasc Interv"},{"key":"7914_CR18","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.jcct.2021.11.013","volume":"16","author":"HN Rashid","year":"2022","unstructured":"Rashid HN, Michail M, Ramnarain J, et al. The impact of hypo-attenuated leaflet thickening on haemodynamic valve deterioration following transcatheter aortic valve replacement. J Cardiovasc Comput Tomogr. 2022;16:168\u201373.","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"7914_CR19","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/j.jcct.2022.11.001","volume":"17","author":"HN Rashid","year":"2023","unstructured":"Rashid HN, Rajani R, Leipsic J, et al. Computed tomography imaging for subclinical leaflet thrombosis following surgical and transcatheter aortic valve replacement. J Cardiovasc Comput Tomogr. 2023;17:2\u201310.","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"7914_CR20","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1016\/j.jcct.2025.04.007","volume":"19","author":"RPJ Budde","year":"2025","unstructured":"Budde RPJ, Faure ME, Abbara S, et al. Cardiac computed tomography for prosthetic heart valve assessment. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Cardiology (ACC), the European Society of Cardiovascular Radiology (ESCR), the North American Society of Cardiovascular Imaging (NASCI), the Radiological Society of North America (RSNA), the Society for Cardiovascular Angiography & Interventions (SCAI) and Society of Thoracic Surgeons (STS). J Cardiovasc Comput Tomogr. 2025;19:366\u201386.","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"7914_CR21","doi-asserted-by":"publisher","first-page":"3003","DOI":"10.1016\/j.jacc.2020.04.043","volume":"75","author":"RR Makkar","year":"2020","unstructured":"Makkar RR, Blanke P, Leipsic J, Thourani V, Chakravarty T, Brown D, et al. Subclinical Leaflet Thrombosis in Transcatheter and Surgical Bioprosthetic Valves: PARTNER 3 Cardiac Computed Tomography Substudy. J Am Coll Cardiol. 2020;75:3003\u201315. https:\/\/doi.org\/10.1016\/j.jacc.2020.04.043.","journal-title":"J Am Coll Cardiol"},{"key":"7914_CR22","doi-asserted-by":"publisher","first-page":"2189","DOI":"10.1056\/NEJMoa2401513","volume":"391","author":"J L\u00f8nborg","year":"2024","unstructured":"L\u00f8nborg J, Jabbari R, Sabbah M, et al. PCI in Patients Undergoing Transcatheter Aortic-Valve Implantation. N Engl J Med. 2024;391:2189\u2013200.","journal-title":"N Engl J Med"},{"key":"7914_CR23","doi-asserted-by":"publisher","unstructured":"Ribichini FL, Scarsini R, Pesarini G, et al. Physiology vs angiography-guided percutaneous coronary intervention in transcatheter aortic valve implantation: the FAITAVI trial. Eur Heart J. 2026;47:3257\u20133266. https:\/\/doi.org\/10.1093\/eurheartj\/ehaf974.","DOI":"10.1093\/eurheartj\/ehaf974"}],"container-title":["Cardiovascular Drugs and Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10557-026-07914-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10557-026-07914-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10557-026-07914-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T01:32:54Z","timestamp":1784251974000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10557-026-07914-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,17]]},"references-count":23,"alternative-id":["7914"],"URL":"https:\/\/doi.org\/10.1007\/s10557-026-07914-2","relation":{},"ISSN":["0920-3206","1573-7241"],"issn-type":[{"value":"0920-3206","type":"print"},{"value":"1573-7241","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,17]]},"assertion":[{"value":"6 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"None.","order":1,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","label":"Competing Interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}