Valvular & structural heart diseaseCohort study
Dual vs Single Antiplatelet Therapy After Transcatheter Aortic Valve Replacement for Bioprosthetic Valve Failure
- Retrospective cohort study
- multicentre
- inverse probability of treatment weighting
Authors' conclusion
DAPT after valve-in-valve TAVR may be associated with a lower 1-year incidence of stroke, whereas no significant difference was observed for other major ischemic and bleeding outcomes or for premature valve deterioration.
Study context
- Population
- Patients treated with valve-in-valve transcatheter aortic valve replacement (TAVR) for surgical bioprosthesis dysfunction at 10 centres; those on OAC excluded
- Participants
- 278 patients
- Exposure
- Dual antiplatelet therapy (DAPT) vs single antiplatelet therapy (SAPT) after valve-in-valve TAVR
Main finding
As reported in the abstract
MACCE and death, DAPT vs SAPT · 1 year
No difference between groups in MACCE: HR 0.499 (95% CI 0.182-1.371)
P = 0.178
No difference between groups in death: HR 0.907 (95% CI 0.272-3.022)
P = 0.874
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Stroke · 1 year · fewer strokes with DAPT | 0.093 (0.010–0.831) | P = 0.033 | |
| 0.050.21520Hazard ratio (log scale) |
Moderate or severe structural valve deterioration · 1 year
- No significant difference between groups (1.9% vs 6.0%)
- P = 0.161
Safety
Major bleeding · 1 year
- No difference between groups: HR 0.776 (95% CI 0.172-3.504)
- P = 0.741
Original publication
Dual vs Single Antiplatelet Therapy After Transcatheter Aortic Valve Replacement for Bioprosthetic Valve Failure. JACC Cardiovasc Interv. Published 3 October 2025. doi:10.1016/j.jcin.2025.09.018
Summarised from the published abstract; every number is checked against it