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

• DOI: 10.1007/s00392-024-02517-z
• Publication Date: 2024-08-19T12:02:42Z
• Authors: Isabel A. Hoerbrand; Martin J. Kraus; Martin Gruber; Nicolas A. Geis; Philipp Schlegel; Norbert Frey; Mathias H. Konsta...
• Keywords: Apixaban; Vitamin K antagonist; Stroke

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