{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:32:31Z","timestamp":1753878751100,"version":"3.41.2"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T00:00:00Z","timestamp":1691107200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There are limited data regarding optimal antiplatelet\/antithrombotic therapy following transcatheter aortic valve replacement (TAVR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this single\u2010centre retrospective study including TAVR patients from 2012 to 2020, ischemic and bleeding outcomes were compared between antiplatelet (dual antiplatelet [DAPT] vs. single antiplatelet [SAPT]) and oral anticoagulation (OAC) groups using incidence rate, Kaplan\u2013Meier and Cox proportional hazards analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Total 492 patients (mean age 79.7\u2009\u00b1\u20097.7\u2009years, 53.7% males, 83.5% Caucasian) were included. There was higher incidence of 1\u2010year death or ischemia with DAPT vs. SAPT (23.6 vs. 14.8 per 100 patient\u2010years [PY], incidence rate ratio [IRR] 1.60, 95% confidence interval [CI] 0.97\u20132.68, <jats:italic>p<\/jats:italic>\u2009=\u2009.05), especially in those without coronary artery disease (23.9 vs. 10.7 per 100 PY, IRR 2.24, 95% CI 1.10\u20134.47, <jats:italic>p<\/jats:italic>\u2009=\u2009.017). There was significantly higher major bleeding in those on OAC vs. no OAC (15 vs. 8 per 100 PY, IRR 1.87, 95% CI 1.10\u20133.11, <jats:italic>p<\/jats:italic>\u2009=\u2009.016), especially late (&gt;1\u2010year) bleeding (10.2 vs. 3.6 per 100 PY, IRR 2.81, 95% CI 1.33\u20135.92, <jats:italic>p<\/jats:italic>\u2009=\u2009.004). In multivariate analysis, DAPT was an independent predictor of death or ischemia (adjusted hazard ratio [aHR] 1.41, 95% CI 1.01\u20131.96, <jats:italic>p<\/jats:italic>\u2009=\u2009.041). OAC was an independent predictor of major bleeding (aHR 2.32, 95% CI 1.31\u20134.13, <jats:italic>p<\/jats:italic>\u2009=\u2009.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is signal to harm with routine use of DAPT post\u2010TAVR. There is higher incidence of late bleeding post\u2010TAVR with OAC, suggesting potential role for alternate antithrombotic strategies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.14071","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T08:44:12Z","timestamp":1691138652000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Optimal antiplatelet and antithrombotic regimen post\u2010transcatheter aortic valve replacement"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8117-0487","authenticated-orcid":false,"given":"Melissa Y. 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