Imperial College London
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DrAhranArnold

Faculty of Medicine, National Heart & Lung Institute

Clinical Senior Lecturer in Cardiology
 
 
 
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Contact

 

ahran.arnold

 
 
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Location

 

Fellows' RoomBlock B Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Ahmad:2018:10.1136/openhrt-2017-000748,
author = {Ahmad, Y and Demir, O and Rajkumar, CA and Howard, J and Shun-Shin, M and Cook, C and Petraco, R and Jabbour, R and Arnold, A and Frame, A and Sutaria, N and Ariff, B and Kanaganayagam, G and Francis, D and Mayet, J and Mikhail, G and Malik, I and Sen, S},
doi = {10.1136/openhrt-2017-000748},
journal = {Open Heart},
title = {Optimal antiplatelet strategy after transcatheter aortic valve implantation: a meta-analysis},
url = {http://dx.doi.org/10.1136/openhrt-2017-000748},
volume = {5},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective International guidelines recommend the use of dual antiplatelet therapy (DAPT) after transcatheter aortic valve implantation (TAVI). The recommended duration of DAPT varies between guidelines. In this two-part study, we (1) performed a structured survey of 45 TAVI centres from around the world to determine if there is consensus among clinicians regarding antiplatelet therapy after TAVI; and then (2) performed a systematic review of all suitable studies (randomised controlled trials (RCTs) and registries) to determine if aspirin monotherapy can be used instead of DAPT.Methods A structured electronic survey regarding antiplatelet use after TAVI was completed by 45 TAVI centres across Europe, Australasia and the USA. A systematic review of TAVI RCTs and registries was then performed comparing DAPT duration and incidence of stroke, bleeding and death. A variance weighted least squared metaregression was then performed to determine the relationship of antiplatelet therapy and adverse events.Results 82.2% of centres routinely used DAPT after TAVI. Median duration was 3 months. 13.3% based their practice on guidelines. 11 781 patients (26 studies) were eligible for the metaregression. There was no benefit of DAPT over aspirin monotherapy for stroke (P=0.49), death (P=0.72) or bleeding (P=0.91).Discussion Aspirin monotherapy appears to be as safe and effective as DAPT after TAVI.
AU  - Ahmad,Y
AU  - Demir,O
AU  - Rajkumar,CA
AU  - Howard,J
AU  - Shun-Shin,M
AU  - Cook,C
AU  - Petraco,R
AU  - Jabbour,R
AU  - Arnold,A
AU  - Frame,A
AU  - Sutaria,N
AU  - Ariff,B
AU  - Kanaganayagam,G
AU  - Francis,D
AU  - Mayet,J
AU  - Mikhail,G
AU  - Malik,I
AU  - Sen,S
DO  - 10.1136/openhrt-2017-000748
PY  - 2018///
SN  - 2053-3624
TI  - Optimal antiplatelet strategy after transcatheter aortic valve implantation: a meta-analysis
T2  - Open Heart
UR  - http://dx.doi.org/10.1136/openhrt-2017-000748
UR  - http://hdl.handle.net/10044/1/55630
VL  - 5
ER  -
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