Valvular & structural heart disease
Short-Term Anticoagulant Therapy and Subclinical Leaflet Thickening in Transcatheter Aortic Valves: The NOTION-4 Trial
Primary result · HALTResult — go to the resultRisk difference −3.9% 95% CI −14.4% to 6.6%Authors' conclusion
Among TAVR patients without an indication for oral anticoagulation, 3 months of DOAC therapy significantly reduced the prevalence of HALT at 3 months compared with SAPT; however, this effect was attenuated by 9 months after discontinuation of DOAC therapy.
Study context
- Population
- Patients without an indication for OAC shortly after successful transcatheter aortic valve replacement (TAVR)5 screen failures or withdrew consent
- Participants
- 352 patients
- Comparison
- 3 months of direct oral anticoagulant (DOAC) then lifelong single antiplatelet therapy (SAPT) vs lifelong SAPT after TAVR
- SAPTn = 176reference
- DOAC-3mn = 171
- Primary endpoint
- Hypoattenuated leaflet thickening (HALT) prevalence
- Follow-up
- 12 months
Methodological detailssuperiority
- Superiority
Primary result
HALT · 1 year
Risk difference
−3.9%
95% CI −14.4% to 6.6%
P = 0.54
By group
DOAC-3m vs SAPT
risk difference −3.9% (95% CI −14.4% to 6.6%); P = 0.54
As reported in the abstract
Further findings
HALT · 3 months
| Outcome | SAPT | DOAC-3m | Risk difference (95% CI) | |
|---|---|---|---|---|
| All-cause mortality, stroke, or major/life-threatening bleeding · 12 months | 2.3% | 8.2% | 5.9% (1.2%–10.6%) | |
| −5051015Difference (linear scale) |
Original publication
Short-Term Anticoagulant Therapy and Subclinical Leaflet Thickening in Transcatheter Aortic Valves: The NOTION-4 Trial. J Am Coll Cardiol. Published 30 August 2026. doi:10.
Summarised from the published abstract; every number is checked against it