Uso de anticoagulantes orales directos en pacientes con fibrilación auricular post implante de TAVI: resultados de una encuesta internacional



Document title: Uso de anticoagulantes orales directos en pacientes con fibrilación auricular post implante de TAVI: resultados de una encuesta internacional
Journal: Revista médica de Chile
Database: PERIÓDICA
System number: 000454994
ISSN: 0034-9887
Authors: 1
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Institutions: 1Hospital Sótero del Río, Santiago. Chile
2Gran Ospedale Metropolitano Niguarda, Milán, Lombardia. Italia
3Hospital Universitario de Salamanca, Salamanca. España
4Sociedad Chilena de Cardiología, Santiago de Chile. Chile
Year:
Season: May
Volumen: 150
Number: 5
Pages: 618-624
Country: Chile
Language: Español
Document type: Artículo
Approach: Aplicado, descriptivo
English abstract Background: Transcatheter Aortic Valve Implantation (TAVI) is beneficial in patients with symptomatic severe Aortic Stenosis (AS). There is no consensus about the best anticoagulation strategy for patients with a recent TAVI and with atrial fibrillation (AF). Direct oral anticoagulants (DOACs) are effective to prevent embolic events with a significant lower incidence of bleeding. There is scarce evidence about the use of these drugs in patients undergoing TAVI. Aim: To assess the management of anticoagulation at the moment of discharge of patients with AF and TAVI. Material and Methods: A four question survey was sent to cardiologists involved in TAVI programs in different international centers. Results: The survey was answered by 72 interventional cardiologists. Even with the lack of randomized evidence, in most of the scenarios DOACs are prescribed at discharge in patients with indication for anticoagulation. Also, in patients with high bleeding risk, most cardiologists would perform a left atrial appendage closure. In patients with concomitant coronary artery disease, if a stent was recently implanted, prescription of the combination of a DOAC and one antiplatelet drug was the most common answer. In patients with a former coronary angioplasty, DOAC or Warfarin was the therapy of choice. Conclusions: In the absence of randomized data, interventional cardiologists prescribe DOACs at discharge to patients with AF and TAVI, without following current guidelines in most cases
Disciplines: Medicina
Keyword: Sistema cardiovascular,
Cirugía,
Farmacología,
Implantación valvular aórtica transcatéter,
Anticoagulantes,
Sobrevivencia
Keyword: Cardiovascular system,
Surgery,
Pharmacology,
Transcatheter aortic valve implantation,
Anticoagulants,
Survival
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