{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:39:57Z","timestamp":1791855597114,"version":"4.3.4"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>The optimal antithrombotic regimen after transcatheter aortic valve replacement remains unclear.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>\n              In this randomized open-label study, low-risk patients undergoing transfemoral transcatheter aortic valve replacement at 7 centers in the United States were randomized 1:1 to low-dose aspirin or warfarin plus low-dose aspirin for 30 days. Patients who could not be randomized were enrolled in a separate registry. Computed tomography or transesophageal echocardiography was performed at 30 days. The primary effectiveness end point was a composite of the following at 30 days: hypoattenuated leaflet thickening, at least moderately reduced leaflet motion, hemodynamic dysfunction (mean aortic valve gradient \u226520 mm\u2009Hg, effective orifice area \u22641.0 cm\n              <jats:sup>2<\/jats:sup>\n              , dimensionless valve index &lt;0.35, or moderate or severe aortic regurgitation), stroke, or transient ischemic attack.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Between July 2018 and October 2019, 94 patients were randomly assigned, 50 to aspirin and 44 to warfarin plus aspirin, and 30 were enrolled into the registry. In the intention-to-treat analysis of the randomized cohort, the composite primary effectiveness end point was met in 26.5% for aspirin versus 7.0% for warfarin plus aspirin (\n              <jats:italic>P<\/jats:italic>\n              =0.014; odds ratio, 4.8 [95% CI, 1.3\u201318.3]). The rate of hypoattenuated leaflet thickening was 16.3% for aspirin versus 4.7% for warfarin plus aspirin (\n              <jats:italic>P<\/jats:italic>\n              =0.07; odds ratio, 4.0 [95% CI, 0.8\u201320.0]). There was no excess bleeding at 30 days with anticoagulation. In the as-treated analysis of pooled randomized and registry cohorts, the rate of hypoattenuated leaflet thickening was 16.7% for aspirin versus 3.1% for warfarin plus aspirin (\n              <jats:italic>P<\/jats:italic>\n              =0.011; odds ratio, 6.3 [95% CI, 1.3\u201330.6]).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In low-risk transcatheter aortic valve replacement patients, anticoagulation with warfarin may prevent transcatheter heart valve dysfunction in the short term without excess bleeding.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT03557242.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.120.009983","type":"journal-article","created":{"date-parts":[[2021,1,11]],"date-time":"2021-01-11T10:07:12Z","timestamp":1610359632000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":50,"title":["Randomized Trial of Aspirin Versus Warfarin After Transcatheter Aortic Valve Replacement in Low-Risk Patients"],"prefix":"10.1161","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct03557242","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Toby","family":"Rogers","sequence":"first","affiliation":[{"name":"Section of Interventional Cardiology (T.R., R.T., C. Shea, C.Z., P.C., I.B.-D., L.F.S., R.W.), MedStar Washington Hospital Center, WA."},{"name":"Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (T.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Shults","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery (C. Shults), MedStar Health Research Institute (F.M.A.), MedStar Washington Hospital Center, WA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Torguson","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology (T.R., R.T., C. Shea, C.Z., P.C., I.B.-D., L.F.S., R.W.), MedStar Washington Hospital Center, WA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corey","family":"Shea","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology (T.R., R.T., C. Shea, C.Z., P.C., I.B.-D., L.F.S., R.W.), MedStar Washington Hospital Center, WA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Puja","family":"Parikh","sequence":"additional","affiliation":[{"name":"Department of Cardiology (P.P.), Stony Brook University Hospital, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Bilfinger","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery (T.B.), Stony Brook University Hospital, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Cocke","sequence":"additional","affiliation":[{"name":"Department of Cardiology (T.C.), The Valley Hospital, Ridgewood, NJ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariano E.","family":"Brizzio","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery (M.E.B.), The Valley Hospital, Ridgewood, NJ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Levitt","sequence":"additional","affiliation":[{"name":"Henrico Cardiology Associates (R.L.), HCA Virginia Health System."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiwon","family":"Hahn","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgical Associates - Richmond (C.H.), HCA Virginia Health System."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Hanna","sequence":"additional","affiliation":[{"name":"Department of Cardiology (N.H.), St. John Health System, Tulsa, OK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Comas","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery (G.C.), St. John Health System, Tulsa, OK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Mahoney","sequence":"additional","affiliation":[{"name":"Department of Cardiology (P.M.), Sentara Norfolk General Hospital, VA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Newton","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery (J.N.), Sentara Norfolk General Hospital, VA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice","family":"Buchbinder","sequence":"additional","affiliation":[{"name":"Department of Cardiology (M.B.), Foundation for Cardiovascular Medicine, San Diego, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery (R.M.), Foundation for Cardiovascular Medicine, San Diego, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology (T.R., R.T., C. 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