{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T05:47:54Z","timestamp":1785044874370,"version":"3.55.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,1,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Clinical evidence on the safety and effectiveness of using direct oral anticoagulants (DOACs) in patients with atrial fibrillation after transcatheter aortic valve replacement (TAVR) remains limited. The aim of this study was to investigate the trends and outcomes of using DOACs in patients with TAVR and atrial fibrillation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Data from the STS\/ACC TVT (Society of Thoracic Surgeons\/American College of Cardiology Transcatheter Valve Therapy) Registry was used to identify patients who underwent successful TAVR with preexisting or incident atrial fibrillation who were discharged on oral anticoagulation between January 2013 and May 2018. Patients with a mechanical valve, valve\u2010in\u2010valve procedure, or prior stroke within a year were excluded. The adjusted primary outcome was 1\u2010year stroke events. The adjusted secondary outcomes included bleeding, intracranial hemorrhage, and death. A total of 21\u00a0131 patients were included in the study (13\u00a0004 TAVR patients were discharged on a vitamin K antagonist and 8127 were discharged on DOACs.) The use of DOACs increased 5.5\u2010fold from 2013 to 2018. The 1\u2010year incidence of stroke was comparable between DOAC\u2010treated patients and vitamin K antagonist\u2010treated patients (2.51% versus 2.37%; hazard ratio [HR], 1.00; 95% CI, 0.81\u20131.23) whereas DOAC\u2010treated patients had lower 1\u2010year incidence of any bleeding (11.9% versus 15.0%; HR, 0.81; 95% CI, 0.75\u20130.89), intracranial hemorrhage (0.33% versus 0.59%; HR, 0.54; 95% CI, 0.33\u20130.87), and death (15.8% versus 18.2%; HR, 0.92; 95% CI, 0.85\u20131.00).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In patients with TAVR and atrial fibrillation, DOAC use, when compared with vitamin K antagonists, was associated with comparable stroke risk and significantly lower risks of bleeding, intracranial hemorrhage, and death at 1\u00a0year.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.023561","type":"journal-article","created":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T11:37:49Z","timestamp":1640950669000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":42,"title":["Use of Direct Oral Anticoagulant and Outcomes in Patients With Atrial Fibrillation after Transcatheter Aortic Valve Replacement: Insights From the STS\/ACC TVT Registry"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2664-6961","authenticated-orcid":false,"given":"Tanyanan","family":"Tanawuttiwat","sequence":"first","affiliation":[{"name":"Krannert Institute of CardiologyIndiana University Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0808-9025","authenticated-orcid":false,"given":"Amanda","family":"Stebbins","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2965-1504","authenticated-orcid":false,"given":"Guillaume","family":"Marquis\u2010Gravel","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1599-2957","authenticated-orcid":false,"given":"Sreekanth","family":"Vemulapalli","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4151-5185","authenticated-orcid":false,"given":"Andrzej S.","family":"Kosinski","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Medicine Johns Hopkins University School of Medicine Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.10.041"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.110981"},{"key":"e_1_3_2_4_2","first-page":"1285","article-title":"Atrial fibrillation in patients undergoing transcatheter aortic valve implantation: epidemiology, timing, predictors, and outcome","volume":"38","author":"Tarantini G","year":"2017","unstructured":"Tarantini G, Mojoli M, Urena M, Vahanian A. Atrial fibrillation in patients undergoing transcatheter aortic valve implantation: epidemiology, timing, predictors, and outcome. 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