Transcatheter Aortic-Valve Implantation (TAVI) is one of the newly discovered minimally invasive procedure to replace a narrowed aortic valve in patients with aortic valve stenosis. Clopidogrel is an antiplatelet medication that is used for anticoagulation after TAVI, but its efficacy has not been well studied. This study aims to investigate the process of anticoagulation with our without clopidogrel in patients who have recently undergone TAVI.

This randomized trial included a total of 157 patients undergoing TAVI who were receiving anticoagulation. The patients were assigned in a 1:1 ratio to receive clopidogrel or not receive clopidogrel for 3 months. The primary outcomes of the study were all bleeding and non-procedure-related bleeding over a period of 12 months. Adverse outcomes, like death from cardiovascular causes, stroke, or myocardial infarction, were also reported.

Of 157 patients in the clopidogrel group, bleeding occurred in 34 (21.7%), as compared with 54 patients (34.6%) in the no-clopidogrel group. Non–procedure-related bleeding was reported in 34 patients (21.7%) and in 53 (34.0%), respectively. Secondary outcomes occurred in 31.2% of patients in the clopidogrel group and 45.5% of patients in the no-clopidogrel group.

The research concluded that among patients undergoing TAVI, anticoagulation with clopidogrel was associated with the reduced incidence of serious bleeding than anticoagulation without clopidogrel.

Ref: https://www.nejm.org/doi/full/10.1056/NEJMoa1915152