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Single antiplatelet therapy reduced risk of mortality and major bleeding in patients undergoing transcatheter aortic valve replacement by half

Large, multi-center registry provides surprising alternative to current standard of care following TAVR for all patients, even those with coronary artery disease

2025-05-01
(Press-News.org) Washington, D.C. – MAY 1, 2025 – Findings from the Transfusion Requirements in Transcatheter Aortic Valve Implantation (TRITAVI) registry demonstrate that single antiplatelet therapy (SAPT) after transcatheter aortic valve replacement (TAVR) is associated with a significantly lower incidence of six-month mortality and major bleeding risk compared to dual antiplatelet therapy (DAPT). The late-breaking data were presented today at the Society for Cardiovascular Angiography & Interventions (SCAI) 2025 Scientific Sessions.

The current standard of care following TAVR is SAPT, which involves the use of only one antiplatelet drug, such as aspirin, to prevent blood clot formation. Traditionally, SAPT is used compared to DAPT, mainly based on the lower bleeding risk; however, the data on mortality are inconclusive. This insight is increasingly important as the number of TAVR procedures performed has steadily increased, making it the most common procedure for patients with aortic stenosis.

Researchers analyzed real-world data from the multicenter TRITAVI registry to determine the differing therapies’ effect on mortality. 5,514 patients (81.5+6.8 years, 48.4% males) were discharged either on SAPT (n=3,197) or DAPT (n=2,317). 

The all-cause mortality and rate of major bleeding at six months were significantly lower in the SAPT group as compared with the DAPT group (2.4% vs 5.4%, and 0.5% vs. 1.3%, respectively). SAPT was associated with lower cardiovascular and non-cardiovascular mortality, as compared to DAPT (1.3% vs 2.2% and 1.1% vs 3.2%, respectively). Sensitivity analyses confirmed that DAPT was significantly associated with mortality both in men (adjusted HR: 2.08; 95% CI: 1.32-3.30) and in women (adjusted HR: 1.53; 95% CI: 1.03-2.29), as well as in patients with coronary artery disease (CAD) (adjusted HR: 1.83; 95% CI: 1.01-3.35) and in patients without CAD (adjusted HR: 1.52; 95% CI: 1.04-2.20). 

“We were surprised to find that SAPT, rather than DAPT, after TAVR is associated with a better outcome, even in patients with CAD,” said Francesco Pelliccia, MD, PhD, Associate Professor of Cardiology at Sapienza University in Rome, Italy, and lead author of the study. “The results, for the first time, provide clinicians more information on how to treat their patients who are at high risk for bleeding and provide evidence that SAPT should be considered the standard of care in all patients undergoing TAVR. 

 

Session Details:

“Antiplatelet Therapy and All-cause Mortality after Transcatheter Aortic Valve Replacement – Insights from the TRITAVI Registry”

Thursday, May 1, 2025; 10:47-10:55 AM ET

Walter E. Washington Convention Center, Exhibit Hall D

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About Society for Cardiovascular Angiography & Interventions (SCAI)

The Society for Cardiovascular Angiography & Interventions, established in 1978, stands as the primary nonprofit medical society dedicated to representing invasive and interventional cardiology. SCAI's mission is to guide the global interventional cardiovascular community by fostering education, advocacy, research, and upholding standards for quality patient care. For more than 40 years, SCAI has exemplified professional excellence and innovation worldwide, cultivating a reputable community of over 5,000 members committed to advancing medical science and providing life-saving care for individuals, both adults and children, affected by cardiovascular disease. For more information, visit https://scai.org/. 

For more information about the SCAI 2025 Scientific Sessions, visit https://scai.org/scai-2025-scientific-sessions. Follow @SCAI on X for the latest heart health news and use #SCAI2025 to follow the latest discussions.

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[Press-News.org] Single antiplatelet therapy reduced risk of mortality and major bleeding in patients undergoing transcatheter aortic valve replacement by half
Large, multi-center registry provides surprising alternative to current standard of care following TAVR for all patients, even those with coronary artery disease