DIRECT ORAL ANTICOAGULANTS VERSUS VITAMIN K ANTAGONIST AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT IN PATIENT WITH ATRIAL FIBRILLATION: A META-ANALYSIS

Wasawat Vutthikraivit; Pattara Rattanawong; Prapaipan Putthapiban; Pavida Pachariyanon; Genanew Bedanie; Kanak Parmar; Elias Hanna

doi:10.1016/S0735-1097(21)02304-4

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DIRECT ORAL ANTICOAGULANTS VERSUS VITAMIN K ANTAGONIST AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT IN PATIENT WITH ATRIAL FIBRILLATION: A META-ANALYSIS

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DIRECT ORAL ANTICOAGULANTS VERSUS VITAMIN K ANTAGONIST AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT IN PATIENT WITH ATRIAL FIBRILLATION: A META-ANALYSIS

Wasawat Vutthikraivit, Pattara Rattanawong, Prapaipan Putthapiban, Pavida Pachariyanon, Genanew Bedanie, Kanak Parmar and Elias Hanna

Journal of the American College of Cardiology, Vol.77(18 Supplement 1), pp.945-945

05/11/2021

DOI: 10.1016/S0735-1097(21)02304-4

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Abstract

Background Atrial fibrillation (AF) is highly prevalent among patients undergoing transcatheter aortic valve replacement (TAVR). Optimal anticoagulation strategy, whether vitamin K antagonist (VKA) or direct oral anticoagulant (DOAC), is controversial in this population. Methods We comprehensively searched the databases of MEDLINE and EMBASE from inception to Dec 2020. Included studies were published cohort that compared clinical outcomes between DOAC-treated and VKA-treated after TAVR in patients with atrial fibrillation. Primary outcome is all-cause mortality. Secondary outcomes are major and/or life-threatening bleeding and stroke. Data from each study were combined using the random-effects model. Results Six cohort studies were included involving 3,490 patients with AF who underwent TAVR (2,328 received VKA and 1,162 received DOAC). There was no significant difference in primary outcome between 2 groups ([OR] 0.88, 95% CI 0.55-1.40, I2=74.7%, p=0.584) (Figure 1). There was also no significant difference found in the secondary outcomes of major and/or life-threatening bleeding and stroke ([OR] 0.85, 95% CI 0.66-1.09, I2=0.0%, p=0.754, and [OR] 1.43, 95% CI 0.90-2.30, I2=0.0%, p=0.872, respectively) (Figure 1). There was no publication bias observed in Funnel plot. Conclusion Our study showed that DOAC was associated with similar clinical outcomes to VKA in TAVR patients with AF. DOAC could be considered as an alternative treatment in this setting.

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Title: Subtitle: DIRECT ORAL ANTICOAGULANTS VERSUS VITAMIN K ANTAGONIST AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT IN PATIENT WITH ATRIAL FIBRILLATION: A META-ANALYSIS
Creators: Wasawat Vutthikraivit - University of Iowa
Pattara Rattanawong - University of Iowa
Prapaipan Putthapiban - University of Iowa
Pavida Pachariyanon - University of Iowa
Genanew Bedanie - University of Iowa
Kanak Parmar - University of Iowa
Elias Hanna - University of Iowa
Resource Type: Abstract
Publication Details: Journal of the American College of Cardiology, Vol.77(18 Supplement 1), pp.945-945
DOI: 10.1016/S0735-1097(21)02304-4
ISSN: 0735-1097
eISSN: 1558-3597
Language: English
Date published: 05/11/2021
Academic Unit: Cardiovascular Medicine; Internal Medicine
Record Identifier: 9984695824802771

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