ACC 2022 | ADAPT-TAVR: Endoxaban Is Not Superior to DAPT After TAVR

DAPT-TAVR is a randomized trial that tested endoxaban in patients with no indication for anticoagulation who underwent successful transcatheter aortic valve replacement (TAVR) for symptomatic severe aortic stenosis.

ACC 2022 | ADAPT-TAVR: Endoxaban No Better Than DAPT After TAVI

This study included 229 patients whose mean age was 80 years; 42% of them were male. Patients were randomized to either endoxaban 60 mg or 30 mg every 24 h or dual antiplatelet therapy (DAPT, aspirin plus clopidogrel).

Low dosage was used in 61.3% of patients because they met one of the following criteria: moderate to severe function impairment, low weight, or concomitant use of P-glycoprotein inhibitors. After 6 months, they were tested by means of 4-dimensional angioTAC, neurological and cognitive assessment, and brain MRI.

Populations were similar, with no difference in characteristics between groups, and 90% received a balloon-expandable valve. The Society of Thoracic Surgeons (STS) score was 3.3%.

After 6 months of follow-up, endoxaban failed to show a significant difference in fewer leafleat thrombosis in the intent-to-treat arm, but there was a difference in patients with high DOAC compliance (9.1% vs. 19.1%; hazard ratio [HR]: 0.48; 95% confidence interval [CI]: 0.23-0.99).

Read also: ACC 2022 | BENTRACIMAB.

There were no differences in the secondary endpoints, which included leaflet mobility reduction ≥3; presence, number and volume of new brain lesions in the MRI; and neurological changes.

Leaflet hypoattenuation was not linked to new brain lesions, neurological disorders, or cognitive disfunction.

Furthermore, there were no differences in the safety endpoints, which included death, stroke, systemic thromboembolism, or bleeding vs. DAPT (11.7% vs. 12.7%; HR: 0.93; 95% CI: 0.44-1.96).

Dr. Carlos Fava - Consejo Editorial SOLACI

Dr. Carlos Fava.
Member of the Editorial Board of SOLACI.org .


Suscríbase a nuestro newsletter semanal

Reciba resúmenes con los últimos artículos científicos

More articles by this author

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Coronary Artery Disease in Aortic Stenosis: CABG + SAVR vs. TAVR + PCI: Data from Spanish Centers

Multiple randomized studies have shown comparable or superior efficacy of transcatheter aortic valve replacement (TAVR) vs. coronary artery bypass graft (CABG).  However, many of...

TCT 2024 | TRISCEND II: A New Hope in Percutaneous Tricuspid Valve Replacement

Advanced tricuspid regurgitation (TR) is a debilitating disease associated with heart failure and increased mortality.  Edge-to-edge repair has been shown to improve both clinical condition...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....