Comparative outcomes of single versus dual antiplatelet therapy following transcatheter aortic valve replacement
10.12007/j.issn.0258-4646.2025.07.009
- VernacularTitle:经导管主动脉瓣置换术后单联抗血小板和双联抗血小板疗效比较
- Author:
Yishan MA
1
;
Liu LI
1
;
Yu WANG
1
;
Jie ZHOU
1
;
Le WANG
1
;
Zhiyu YANG
1
Author Information
1. 河北医科大学第一医院心内科,石家庄 050011
- Publication Type:Journal Article
- Keywords:
transcatheter aortic valve replacement;
antiplatelet therapy;
bleeding events
- From:
Journal of China Medical University
2025;54(7):626-630,637
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effects of single antiplatelet therapy(SAPT)versus dual antiplatelet therapy(DAPT)on bleeding and ischemic events in patients undergoing transcatheter aortic valve replacement(TAVR)without long-term anticoagulation indications.Methods This randomized controlled trial included 90 post-TAVR patients without anticoagulation indications,who were allocated to the SAPT group(n=46,aspirin 100 mg/d)or DAPT group(n=44,aspirin 100 mg/d+clopidogrel 75 mg/d for 3 months,followed by aspirin monotherapy).Maximum aggregation rates of platelets induced by arachidonic acid(MARAA)and adenosine diphosphate(MARADP)were measured 1,3,6,and 12 months postoperatively.Bleeding and ischemic events were recorded during the follow-up visits.Results The SAPT group exhibited significantly higher MARAA and MARADP scores at 1 and 3 months,and higher MARAA scores at 6 months compared to the DAPT group(P<0.05).At the 12-month follow-up,the SAPT group had a significantly lower inci-dence of bleeding events compared to the DAPT group(13.0%vs.31.8%,P=0.043).No statistically significant difference was observed in ischemic events between the groups(15.2%vs.11.4%,P=0.759).Conclusion For TAVR patients without anticoagulation indica-tions,SAPT significantly reduced the 1-year bleeding risk compared to DAPT,without increasing ischemic events.These findings support the safety and efficacy of SAPT after TAVR.
