Favorable safety profile of NOAC therapy in patients after tricuspid transcatheter edge-to-edge repair

• Verfasst von: Hörbrand, Isabel [VerfasserIn]
• Verfasst von: Volz, Martin J. [VerfasserIn]
• Verfasst von: Gruber, Martin [VerfasserIn]
• Verfasst von: Geis, Nicolas [VerfasserIn]
• Verfasst von: Schlegel, Philipp [VerfasserIn]
• Verfasst von: Frey, Norbert [VerfasserIn]
• Verfasst von: Konstandin, Mathias [VerfasserIn]
• Titel: Favorable safety profile of NOAC therapy in patients after tricuspid transcatheter edge-to-edge repair
• Verf.angabe: Isabel A. Hoerbrand, Martin J. Kraus, Martin Gruber, Nicolas A. Geis, Philipp Schlegel, Norbert Frey, Mathias H. Konstandin
• Jahr: 2025
• Umfang: 10 S.
• Illustrationen: Illustrationen
• Fussnoten: Zuerst veröffentlicht: 19. August 2024 ; Gesehen am 04.11.2024
• Titel Quelle: Enthalten in: Clinical research in cardiology
• Ort Quelle: Berlin : Springer, 2006
• Jahr Quelle: 2025
• Band/Heft Quelle: 114(2025), Seite 846-855
• ISSN Quelle: 1861-0692
• DOI: doi:10.1007/s00392-024-02517-z
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Bleeding
• Sach-SW: NOAC
• Sach-SW: Oral anticoagulation
• Sach-SW: Transcatheter edge-to-edge repair
• Sach-SW: Transcatheter tricuspid valve repair
• Sach-SW: Tricuspid disease
• Sach-SW: Tricuspid regurgitation
• K10plus-PPN: 1907501460

Abstract

Background: Transcatheter edge-to-edge repair for severe tricuspid regurgitation (TR) is a new treatment option (t-TEER). Data on optimal antithrombotic therapy after t-TEER in patients with an indication for anticoagulation are scarce and evidence-based guideline recommendations are lacking. We sought to investigate efficacy and safety of novel oral anticoagulation (NOAC) and vitamin-K-antagonists (VKA) in patients undergoing t-TEER. Methods: Among 78 consecutive patients with t-TEER of severe TR, 69 patients were identified with concomitant indication for oral anticoagulation. Outcomes of these patients treated with NOAC or VKA were compared over a median follow-up period of 327 (177–460) days. Results: Despite elevated thromboembolic and bleeding risk scores (CHA2DS2-VASc 4.2 ± 1.1, HEMORR2HAGES 3.0 ± 1.0 and HAS-BLED 2.1 ± 0.8), only one major bleeding incidence occurred under NOAC therapy. The risk for overall (NOAC 8% vs. VKA group 26%, p = 0.044) and major bleeding events (NOAC 2% vs. VKA 21%, p = 0.010) was significantly lower in the NOAC compared to the VKA group. No significant difference was found between NOAC and VKA treatment in terms of mortality (NOAC 18% vs. VKA 16%, p = 0.865) or the combined endpoint of death, heart failure hospitalization, stroke, embolism, thrombosis, myocardial infarction, and severe bleeding (NOAC 48% vs. VKA 42%, p = 0.801). A comparison between apixaban (n = 27) and rivaroxaban (n = 16) treated patients revealed no significant differences between NOAC substances (all bleeding events apixaban 7% vs. rivaroxaban 13%, p = 0.638). Conclusion: Results of this study indicate that NOACs may offer a favorable risk–benefit profile for patients with concomitant indication for anticoagulation therapy following t-TEER.