Valvular & structural heart disease

An investigator-sponsored pragmatic randomized controlled trial of AntiCoagulation vs AcetylSalicylic Acid after Transcatheter Aortic Valve Implantation: Rationale and design of ACASA-TAVI

Am Heart JPublished Rationale and design of a randomised controlled trial

Study context

Population
Patients after successful transcatheter aortic valve implantation (TAVI) without indication for OACplanned
Participants
360 patients
Comparison
Anti-factor Xa NOAC monotherapy vs single antiplatelet therapy (acetylsalicylic acid) after TAVI
Primary endpoint
Co-primary: (1) Hypo-Attenuated Leaflet Thickening (HALT) on 4-dimensional cardiac CT; (2) safety composite of VARC-3 bleeding, thromboembolic events (MI and stroke) and all-cause death
Follow-up
12 months
Methodological detailsmulticentre, prospective, open-label, blinded endpoint, all-comers, pragmatic, 1:1 randomisation
  • Multicentre
  • Prospective
  • Open-label
  • Blinded endpoint
  • All-comers
  • Pragmatic
  • 1:1 randomisation

Primary result

As reported in the abstract

Baseline characteristics of first 100 patients
Mean age (years)
74 ± 3.6
Female
33%
Mean BMI (kg/m²)
27.9 ± 4.4
Smokers
15%
Balloon-expanded valve
82%
Self-expandable valve
18%

Original publication

An investigator-sponsored pragmatic randomized controlled trial of AntiCoagulation vs AcetylSalicylic Acid after Transcatheter Aortic Valve Implantation: Rationale and design of ACASA-TAVI. Am Heart J. Published 25 August 2023. doi:10.1016/j.ahj.2023.08.010

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