Once again, DAPT proven to cause more harm than good

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Takeaway

  • Preprocedural dual antiplatelet therapy (DAPT) before transfemoral transcatheter aortic valve implantation (TF-TAVI) leads to a higher incidence of bleeding with no clinical benefit of reduce thrombotic events compared with either preprocedural single antiplatelet therapy (SAPT) or no antiplatelet therapy (APT) at all.

Study design

  • A retrospective analysis of a prospective, multicenter, observational, cohort registry.
  • 540 patients (median age, 85 y; 68.1% female) underwent TF-TAVI between October 2013 and July 2015.
  • 167 patients received preprocedural SAPT, 293 patients received preprocedural DAPT, and 80 patients had no preprocedural APT.
  • Funding: Source of funding not disclosed.

Key results

  • Overall, 31.4% experienced bleeding, 28.9% required transfusions, 1.7% died, 2.6% experienced stroke, and 0.6% had myocardial infarction.
  • No incidence of thrombosis in total cohort.
  • Bleeding was significantly higher in patients on DAPT compared to no pre TAVI APT and SAPT groups (36.5% vs 25.5%; P=.006).
  • Patients on DAPT had a significantly higher...