{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T21:53:06Z","timestamp":1778104386734,"version":"3.51.4"},"reference-count":30,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fonds de Recherche du Qu\u00e9bec\u2014Sant\u00e9"},{"name":"Fondation de l\u2019Institut Universitaire de Cardiologie et Pneumologie de Qu\u00e9bec"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The recommendations for antithrombotic therapy after transcatheter edge-to-edge mitral valve repair (TEER) are empirical, and the benefit of antiplatelet (APT) or anticoagulation therapy (ACT) remains undetermined. The study sought to investigate the degree and the timing of coagulation and platelet marker activation after TEER. Methods: This was a prospective study including 46 patients undergoing TEER. The markers of coagulation activation, namely prothrombin fragment 1 + 2 (F1 + 2) and thrombin-antithrombin III (TAT), and the markers of platelet activation, namely soluble P-Selectin and soluble CD-40 ligand (sCD40L), were measured at baseline, 24 h, 1 month, and 1 year after TEER. Results: At discharge, 20 (43%) patients received APT (single: 16, dual: 4), 24 (52%) received ACT, and 2 (4%) had both single APT and ACT. Levels of F1 + 2 and TAT significantly increased at 24 h post TEER (both p &lt; 0.001), rapidly returning to baseline levels at 1 month. However, levels of F1 + 2 and TAT remained higher at 1 month in patients without ACT compared to patients with ACT (respectively, 303.1 vs. 148.1 pmol\/L; p &lt; 0.001 and 4.6 vs. 3.0 \u00b5g\/L; p = 0.020), with a similar trend at 1 year. Levels of soluble P-selectin and sCD40L remained stable at all times after TEER (respectively, p = 0.071 and p = 0.056), regardless of the APT. Conclusions: TEER is associated with an acute activation of the coagulation system, with no increase in platelet activation markers. Hence, the use of dual APT is questionable in this population. Our results raise the hypothesis that the optimal antithrombotic therapy after TEER could be short-term ACT over APT. Further larger studies are warranted.<\/jats:p>","DOI":"10.3390\/jcm14030831","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T08:57:48Z","timestamp":1738054668000},"page":"831","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evolution of Coagulation and Platelet Activation Markers After Transcatheter Edge-to-Edge Mitral Valve Repair"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2766-1461","authenticated-orcid":false,"given":"Sandra","family":"Hadjadj","sequence":"first","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, QC G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Beaudoin","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, QC G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0630-3144","authenticated-orcid":false,"given":"Fr\u00e9d\u00e9ric","family":"Beaupr\u00e9","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, QC G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Gravel","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, QC G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ons","family":"Marsit","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, QC G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvain","family":"Pouliot","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, QC G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2240-8456","authenticated-orcid":false,"given":"Benoit J.","family":"Arsenault","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, QC G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Pibarot","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, QC G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8353-7625","authenticated-orcid":false,"given":"Julio","family":"Farjat-Pasos","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, QC G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Nuche-Berenguer","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, QC G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0389-8325","authenticated-orcid":false,"given":"Beno\u00eet","family":"M-Labb\u00e9","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, QC G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"O\u2019Connor","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, QC G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9240-3816","authenticated-orcid":false,"given":"Mathieu","family":"Bernier","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, QC G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erwan","family":"Salaun","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, QC G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep","family":"Rod\u00e9s-Cabau","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, QC G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Michel","family":"Paradis","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec, QC G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"ref_1","first-page":"e35","article-title":"2020 ACC\/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"143","author":"Otto","year":"2021","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","article-title":"2021 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"43","author":"Vahanian","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1016\/j.jacc.2009.03.077","article-title":"Percutaneous mitral repair with the MitraClip system: Safety and midterm durability in the initial EVEREST (Endovascular Valve Edge-to-Edge REpair Study) cohort","volume":"54","author":"Feldman","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1056\/NEJMoa1009355","article-title":"Percutaneous repair or surgery for mitral regurgitation","volume":"364","author":"Feldman","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2307","DOI":"10.1056\/NEJMoa1806640","article-title":"Transcatheter Mitral-Valve Repair in Patients with Heart Failure","volume":"379","author":"Stone","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1177\/1076029607309176","article-title":"Elevated levels of prothrombin fragment 1 + 2 indicate high risk of thrombosis","volume":"14","author":"Ota","year":"2008","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/S0167-5273(98)00256-3","article-title":"Prothrombin fragments F1+2, thrombin-antithrombin III complexes, fibrin monomers and fibrinogen in patients with coronary atherosclerosis","volume":"68","author":"Giannitsis","year":"1999","journal-title":"Int. J. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1055\/s-0038-1656116","article-title":"The origin of P-selectin as a circulating plasma protein","volume":"77","author":"Fijnheer","year":"1997","journal-title":"Thromb. Haemost."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.thromres.2013.08.014","article-title":"The role of soluble P selectin in the diagnosis of venous thromboembolism","volume":"133","author":"Antonopoulos","year":"2014","journal-title":"Thromb. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1056\/NEJMoa022600","article-title":"Soluble CD40 ligand in acute coronary syndromes","volume":"348","author":"Heeschen","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.1161\/01.STR.0000074032.64049.47","article-title":"Upregulation of CD40-CD40 ligand (CD154) in patients with acute cerebral ischemia","volume":"34","author":"Garlichs","year":"2003","journal-title":"Stroke"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1016\/j.echo.2007.02.003","article-title":"Echocardiographic guidance and assessment of percutaneous repair for mitral regurgitation with the Evalve MitraClip: Lessons learned from EVEREST I","volume":"20","author":"Silvestry","year":"2007","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1878","DOI":"10.1093\/eurheartj\/ehv333","article-title":"Clinical trial design principles and endpoint definitions for transcatheter mitral valve repair and replacement: Part 2: Endpoint definitions: A consensus document from the Mitral Valve Academic Research Consortium","volume":"36","author":"Stone","year":"2015","journal-title":"Eur. Heart J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.ijcard.2004.03.022","article-title":"Assessment of the markers of platelet and coagulation activation following transcatheter closure of atrial septal defects","volume":"98","author":"Palacios","year":"2005","journal-title":"Int. J. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.carpath.2008.07.001","article-title":"Mitral repair with the Evalve MitraClip device: Histopathologic findings in the porcine model","volume":"18","author":"Luk","year":"2009","journal-title":"Cardiovasc. Pathol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1016\/j.biomaterials.2004.05.036","article-title":"Material-specific thrombin generation following contact between metal surfaces and whole blood","volume":"26","author":"Hong","year":"2005","journal-title":"Biomaterials"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1002\/clc.4960200104","article-title":"Biochemical markers of coagulation activation in mitral stenosis, atrial fibrillation, and cardiomyopathy","volume":"20","author":"Ikeda","year":"1997","journal-title":"Clin. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"660","DOI":"10.2459\/JCM.0000000000000838","article-title":"Does mitral regurgitation reduce the risks of thrombosis in atrial fibrillation and flutter?","volume":"20","author":"Cresti","year":"2019","journal-title":"J. Cardiovasc. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.amjcard.2017.03.253","article-title":"Changes in Coagulation and Platelet Activation Markers Following Transcatheter Left Atrial Appendage Closure","volume":"120","author":"Paradis","year":"2017","journal-title":"Am. J. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1161\/01.STR.0000251712.55322.69","article-title":"Enhanced thrombogenesis but not platelet activation is associated with transcatheter closure of patent foramen ovale in patients with cryptogenic stroke","volume":"38","author":"Houde","year":"2007","journal-title":"Stroke"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e009039","DOI":"10.1161\/CIRCINTERVENTIONS.120.009039","article-title":"Short-Term Oral Anticoagulation Versus Antiplatelet Therapy Following Transcatheter Left Atrial Appendage Closure","volume":"13","author":"Asmarats","year":"2020","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1067\/mcp.2003.13","article-title":"Clopidogrel but not aspirin reduces P-selectin expression and formation of platelet-leukocyte aggregates in patients with atherosclerotic vascular disease","volume":"73","author":"Klinkhardt","year":"2003","journal-title":"Clin. Pharmacol. Ther."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1067\/mhj.2001.116478","article-title":"Uniform platelet activation exists before coronary stent implantation despite aspirin therapy","volume":"142","author":"Serebruany","year":"2001","journal-title":"Am. Heart J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.vph.2015.07.015","article-title":"Platelet reactivity in MitraClip patients","volume":"77","author":"Polzin","year":"2016","journal-title":"Vasc. Pharmacol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"317","DOI":"10.3109\/09537104.2015.1096335","article-title":"Antiplatelet effects of clopidogrel and aspirin after interventional patent foramen ovale\/atrium septum defect closure","volume":"27","author":"Polzin","year":"2016","journal-title":"Platelets"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.ijcard.2018.10.040","article-title":"Antiplatelet effects of aspirin and clopidogrel after left atrial appendage (LAA) occluder implantation","volume":"275","author":"Dannenberg","year":"2019","journal-title":"Int. J. Cardiol."},{"key":"ref_27","first-page":"e523","article-title":"Focused update incorporated into the ACC\/AHA 2006 guidelines for the management of patients with valvular heart disease: A report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons","volume":"118","author":"Bonow","year":"2008","journal-title":"Circulation"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1080\/00015385.2018.1550886","article-title":"Temporary oral anticoagulation after MitraClip\u2014A strategy to lower the incidence of post-procedural stroke?","volume":"75","author":"Geis","year":"2020","journal-title":"Acta Cardiol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Waechter, C., Ausbuettel, F., Chatzis, G., Cheko, J., Fischer, D., Nef, H., Barth, S., Halbfass, P., Deneke, T., and Mueller, J. (2022). Antithrombotic Treatment and Its Association with Outcome in a Multicenter Cohort of Transcatheter Edge-to-Edge Mitral Valve Repair Patients. J. Cardiovasc. Dev. Dis., 9.","DOI":"10.3390\/jcdd9110366"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1007\/s00392-022-01988-2","article-title":"Real-world anticoagulatory treatment after percutaneous mitral valve repair using MitraClip: A retrospective, observational study on 1300 patients","volume":"111","author":"Hohmann","year":"2022","journal-title":"Clin. Res. Cardiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/831\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:36:59Z","timestamp":1759919819000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/831"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,27]]},"references-count":30,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["jcm14030831"],"URL":"https:\/\/doi.org\/10.3390\/jcm14030831","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,27]]}}}