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Direct oral anticoagulants may best vitamin K agonists for post-TAVR a-fib

Journal
JACC: Cardiovascular Interventions
Reuters Health - 12/11/2020 - In patients with atrial fibrillation (AF) after transcatheter aortic valve replacement (TAVR), direct oral anticoagulants (DOACs) were associated with lower long-term all-cause mortality than vitamin K agonists (VKAs) in a Japanese registry study. "We are surprised by the result," Dr. Yusuke Watanabe of Teikyo University School of Medicine told Reuters Health by email. "For clinicians right now, we think in patients undergoing TAVR with a high risk for bleeding, DOACs should be the first choice for an antithrombotic regimen. A contraindication is severe renal dysfunction. Also, concomitant use of antiplatelet therapy should be kept to a minimum." As reported in JACC: Cardiovascular Interventions, the study included 403 TAVR patients with AF on anticoagulant therapy (mean age 84; 33% men) enrolled in the multicenter Optimized Transcatheter Valvular Intervention (OCEAN) registry from 2013-2017. Median follow-up was 568 days. Among ...


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