Abstract
SINGLE VS. DUAL ANTIPLATELET THERAPY IN POST-TAVR PATIENTS: A SYSTEMATIC REVIEW

Benish Alam*, Iqra Mukhtar, Maryam Ahmed, Muhammad Idrees, Mohammed Numaan Ahmed, Danish Waqar, Shilpa Rai, Shaffiq Yusuf, Olubukola Oloniyo, Sally Fouda, Uyi Osunde, Ademidun O. Ayoade, Stephen Dada, Mayowa Stephen Apata and Frederick Ferguson

ABSTRACT

Introduction: Transcatheter aortic valve replacement (TAVR) is provided to patients with severe symptomatic aortic valve stenosis who are considered high risk candidates for surgical aortic valve replacement (SAVR). We compared the efficacy and safety of TAVR with single vs dual antiplatelet therapy. Methods: The systematic review was performed as per the Cochrane methods. We searched relevant databases until December 27, 2021. We chose studies as per the inclusion criteria and used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: A total of 4 RCTs were included with 1,086 patients and an average follow-up of 9.2 months. The baseline clinical characteristics were comparable in either group receiving single vs. dual antiplatelet therapy. There was a lower incidence of life-threatening bleeding and myocardial infarction in the SAPT group. Conclusion: The incidence of bleeding was significantly reduced with SAPT with no major increase in stroke risk demonstrating the lack of inferiority with SAPT regimen post-TAVR.

Keywords: Single antiplatelet therapy, dual antiplatelet therapy, aspirin, clopidogrel, TAVR.


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