Journal of Thrombosis and Thrombolysis

, Volume 44, Issue 4, pp 448–456 | Cite as

Single versus dual anti-platelet therapy post transcatheter aortic valve implantation: a meta-analysis of randomized controlled trials

  • Tomo Ando
  • Hisato Takagi
  • Alexandros Briasoulis
  • Luis Afonso
Article
  • 174 Downloads

Abstract

The purpose of this systematic review and meta-analysis was to assess the 30-days safety (bleeding and vascular events) and efficacy (reduction in major stroke, myocardial infarction and mortality) of single anti-platelet (SAPT) versus dual anti-platelet (DAPT) after transcatheter aortic valve implantation (TAVI). We used a meta-analytic method with Mantel–Haenszel methods to calculate the odds ratio (OR) and 95% confidence interval (CI). Only randomized clinical trials that compared 30-days safety and efficacy based on Valve Academic Research Consortium criteria were included. Studies that included patients on anticoagulants were excluded. Our analysis included three studies with a total of 421 patients (210 SAPT and 211 DAPT). Life-threatening and major bleeding as well as major vascular complications was similar between SAPT and DAPT. Similarly, major stroke, myocardial infarction and mortality was also comparable between the two groups. The combined outcomes of 30-day mortality, life-threatening and major bleeding showed tendency toward lower event rates in SAPT compared to DAPT (9.5 vs. 15.6%, OR 0.57; 95% CI 0.31–1.03, p = 0.06). In conclusion, SAPT provided similar safety without adding incremental efficacy compared to DAPT but showed tendency of lower combined endpoints of 30-day mortality, life-threatening and major bleeding.

Keywords

Transcatheter aortic valve implantation Single antiplatelet therapy Dual antiplatelet therapy 

Notes

Funding

There was no funding for this research.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

This was a systematic review of the previously published original articles and therefore in accordance with the ethical standards.

Ethical approval

This was a systematic review of the previously published articles and therefore did not require approval from institutional board review.

Supplementary material

11239_2017_1550_MOESM1_ESM.tiff (25.8 mb)
Supplementary material 1—Flow chart of study selection (TIFF 26369 KB)

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Tomo Ando
    • 1
    • 4
  • Hisato Takagi
    • 2
  • Alexandros Briasoulis
    • 3
  • Luis Afonso
    • 1
  1. 1.Division of Cardiovascular Disease, Department of Internal Medicine, Harper hospitalWayne State UniversityDetroitUSA
  2. 2.Division of Cardiovascular Surgery, Department of SurgeryShizuoka Medical CenterShizuokaJapan
  3. 3.Division of Cardiovascular Disease, Department of Internal MedicineMayo ClinicRochesterUSA
  4. 4.Division of CardiologyDetroit Medical CenterDetroitUSA

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