An Update on Anti-thrombotic Therapy Following Transcatheter Aortic Valve Implantation: Expert Cardiologist Opinion from a UK and Ireland Delphi Group
Transcatheter aortic valve implantation (TAVI) is an effective and established treatment for symptomatic aortic stenosis. However, there is a lack of consensus concerning the need for peri- and post-procedural anti-thrombotic medication. Contemporary guidelines recommend that anti-thrombotic therapy...
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| Format: | Article |
| Language: | English |
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Radcliffe Medical Media
2023-04-01
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| Series: | Interventional Cardiology: Reviews, Research, Resources |
| Online Access: | https://www.icrjournal.com/articleindex/icr.2022.11 |
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| author | Azfar Zaman Bernard Prendergast David Hildick-Smith Daniel Blackman Richard Anderson Mark S Spence Darren Mylotte David Smith Ben Wilding Chris Chapman Kirsty Atkins Kevin G Pollock Ayesha C Qureshi Adrian Banning |
| author_facet | Azfar Zaman Bernard Prendergast David Hildick-Smith Daniel Blackman Richard Anderson Mark S Spence Darren Mylotte David Smith Ben Wilding Chris Chapman Kirsty Atkins Kevin G Pollock Ayesha C Qureshi Adrian Banning |
| author_sort | Azfar Zaman |
| collection | DOAJ |
| description | Transcatheter aortic valve implantation (TAVI) is an effective and established treatment for symptomatic aortic stenosis. However, there is a lack of consensus concerning the need for peri- and post-procedural anti-thrombotic medication. Contemporary guidelines recommend that anti-thrombotic therapy is balanced against a patient’s bleeding risk following TAVI, but do not fully consider the evolving evidence base. The purpose of the Delphi panel recommendations presented here is to provide a consensus elicited from a panel of experts who regularly prescribe anti-thrombotic therapy post-TAVI. The goal was to address evidence gaps across four key topics: anti-thrombotic therapy (anti-platelet and/or anti-coagulant) in TAVI patients in sinus rhythm; anti-thrombotic therapy in TAVI patients with AF; direct oral anti-coagulants versus vitamin K antagonists; and the need for UK/Ireland specific guidance. This consensus statement aims to inform clinical decision-making by providing a concise, evidence-based summary of best practice for prescribing anti-thrombotic therapies following TAVI and highlights areas where further research is needed. |
| format | Article |
| id | doaj-art-80578807c09b46e3aaec3ad589cdbfbf |
| institution | OA Journals |
| issn | 1756-1477 1756-1485 |
| language | English |
| publishDate | 2023-04-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | Interventional Cardiology: Reviews, Research, Resources |
| spelling | doaj-art-80578807c09b46e3aaec3ad589cdbfbf2025-08-20T02:37:42ZengRadcliffe Medical MediaInterventional Cardiology: Reviews, Research, Resources1756-14771756-14852023-04-011810.15420/icr.2022.11An Update on Anti-thrombotic Therapy Following Transcatheter Aortic Valve Implantation: Expert Cardiologist Opinion from a UK and Ireland Delphi GroupAzfar Zaman0Bernard Prendergast1David Hildick-Smith2Daniel Blackman3Richard Anderson4Mark S Spence5Darren Mylotte6David Smith7Ben Wilding8Chris Chapman9Kirsty Atkins10Kevin G Pollock11Ayesha C Qureshi12Adrian Banning13Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, UK; Newcastle University, Newcastle upon Tyne, UKDepartment of Cardiology, St Thomas’ Hospital, London, UK; Cleveland Clinic, London, UKSussex Cardiac Centre, Regional Specialist Unit, Brighton and Sussex University Hospitals, Brighton, UKDepartment of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UKDepartment of Cardiology, University Hospital of Wales, Cardiff, UK; Cardiff Metropolitan University, Cardiff, UKDepartment of Cardiology, Mater Private Hospital, Dublin, IrelandDepartment of Cardiology, University Hospitals Galway, Galway, Ireland; National University of Galway, Galway, IrelandDepartment of Cardiology, Morriston Hospital, Swansea, UK; University of Swansea, Swansea, UKHealth Economics and Outcomes Research, Cardiff, UKBristol Myers Squibb Pharmaceuticals, Uxbridge, Middlesex, UKBristol Myers Squibb Pharmaceuticals, Uxbridge, Middlesex, UKBristol Myers Squibb Pharmaceuticals, Uxbridge, Middlesex, UKBristol Myers Squibb Pharmaceuticals, Princeton, NJ, USDepartment of Cardiology, John Radcliffe Hospital, Oxford, UKTranscatheter aortic valve implantation (TAVI) is an effective and established treatment for symptomatic aortic stenosis. However, there is a lack of consensus concerning the need for peri- and post-procedural anti-thrombotic medication. Contemporary guidelines recommend that anti-thrombotic therapy is balanced against a patient’s bleeding risk following TAVI, but do not fully consider the evolving evidence base. The purpose of the Delphi panel recommendations presented here is to provide a consensus elicited from a panel of experts who regularly prescribe anti-thrombotic therapy post-TAVI. The goal was to address evidence gaps across four key topics: anti-thrombotic therapy (anti-platelet and/or anti-coagulant) in TAVI patients in sinus rhythm; anti-thrombotic therapy in TAVI patients with AF; direct oral anti-coagulants versus vitamin K antagonists; and the need for UK/Ireland specific guidance. This consensus statement aims to inform clinical decision-making by providing a concise, evidence-based summary of best practice for prescribing anti-thrombotic therapies following TAVI and highlights areas where further research is needed.https://www.icrjournal.com/articleindex/icr.2022.11 |
| spellingShingle | Azfar Zaman Bernard Prendergast David Hildick-Smith Daniel Blackman Richard Anderson Mark S Spence Darren Mylotte David Smith Ben Wilding Chris Chapman Kirsty Atkins Kevin G Pollock Ayesha C Qureshi Adrian Banning An Update on Anti-thrombotic Therapy Following Transcatheter Aortic Valve Implantation: Expert Cardiologist Opinion from a UK and Ireland Delphi Group Interventional Cardiology: Reviews, Research, Resources |
| title | An Update on Anti-thrombotic Therapy Following Transcatheter Aortic Valve Implantation: Expert Cardiologist Opinion from a UK and Ireland Delphi Group |
| title_full | An Update on Anti-thrombotic Therapy Following Transcatheter Aortic Valve Implantation: Expert Cardiologist Opinion from a UK and Ireland Delphi Group |
| title_fullStr | An Update on Anti-thrombotic Therapy Following Transcatheter Aortic Valve Implantation: Expert Cardiologist Opinion from a UK and Ireland Delphi Group |
| title_full_unstemmed | An Update on Anti-thrombotic Therapy Following Transcatheter Aortic Valve Implantation: Expert Cardiologist Opinion from a UK and Ireland Delphi Group |
| title_short | An Update on Anti-thrombotic Therapy Following Transcatheter Aortic Valve Implantation: Expert Cardiologist Opinion from a UK and Ireland Delphi Group |
| title_sort | update on anti thrombotic therapy following transcatheter aortic valve implantation expert cardiologist opinion from a uk and ireland delphi group |
| url | https://www.icrjournal.com/articleindex/icr.2022.11 |
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