Physicians' Academy for Cardiovascular Education

No reduction in cerebral thromboembolism with DOAC after TAVR

News - Apr. 5, 2022

Edoxaban Versus Dual Antiplatelet Therapy For Valve Thrombosis And Cerebral Thromboembolism After Transcatheter Aortic-valve Replacement: A Randomized ADAPT-TAVR Trial

Presented at ACC.22 by Duk-Woo Park, MD, PhD (Seoul, Korea)

Introduction and methods

This multicenter, open-label randomized trial investigated whether edoxaban, compared to DAPT can reduce leaflet thrombosis, cerebral thromboembolism and neurological/neurocognitive dysfunction after transcatheter aortic-valve replacement (TAVR).

A total of 229 patients who had undergone successful TAVR and without an indication for long-term anticoagulation were randomized to receive edoxaban (n=110, 60 mg or 30 mg once daily) or DAPT (aspirin [100 mg once daily] plus clopidogrel [75 mg once daily]) for 6 months.

The primary endpoint was incidence of valve leaflet thrombosis on four-dimensional CT at 6 months. Key secondary endpoints were number of new cerebral lesions and total new lesion volume on brain MRI and changes in neurological/neurocognitive function tests between baseline and 6 months.



In patients without an indication for long-term anticoagulation after successful TAVR, 6-months treatment with edoxaban, compared with DAPT, did not results in significant reductions in incidence of leaflet thrombosis, cerebral thromboembolism, or neurological/neurocognitive dysfunction.

– Our coverage of ACC.22 is based on the information provided during the congress –

The results of this study were simultaneously published in Circulation.

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