Results from the POPular TAVI trial, presented as a Hot Line session at this year’s European Society of Cardiologists (ESC) Congress, have shown aspirin monotherapy to be superior to dual therapy with clopidogrel as an anti-platelet strategy, in people not on oral anticoagulants, following transcatheter aortic valve implantation (TAVI) for aortic stenosis.
In this study, 665 patients were randomly assigned to take aspirin monotherapy (n= 331) or aspirin with an initial three months of combination therapy with clopidogrel (n=334). The results demonstrated that the aspirin alone strategy led to significantly fewer bleeding events at one year (15.1 % of people receiving aspirin monotherapy versus 26.6% of people taking the initial combination antiplatelet strategy had a bleeding event). Aspirin alone was also not inferior to the combination antiplatelet therapy with 9.7 % of patients in the aspirin monotherapy group having a thromboembolic event (a combination of cardiovascular mortality, ischaemic stroke or myocardial infarction) compared to 9.9% of those taking aspirin with an additional three months of clopidogrel (difference -8.2 percentage points; 95% CI for noninferiority -14.9 to -1.5; p<0.001; RR 0.74; 95% CI for superiority 0.57-0.95; p=0.04). .
Dr John Brouwer, the coordinating investigator for this study said: “the trial shows that aspirin alone should be used in patients undergoing TAVI who are not on oral anticoagulants and have not recently undergone coronary stenting.”
For further information please see:
Study reveals best anticlotting strategy after heart valve intervention. Available @
Published: 11th September 2020