<div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" paraid="1804483911" paraeid="{c03729c9-2e1f-486d-9602-5e95746373fb}{12}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW243402020 BCX0"><span class="NormalTextRun SCXW243402020 BCX0">Anticoagulation</span><span> </span><span class="NormalTextRun SCXW243402020 BCX0">mono</span><span class="NormalTextRun SCXW243402020 BCX0">therapy</span><span> </span><span class="NormalTextRun SCXW243402020 BCX0">aft</span><span class="NormalTextRun SCXW243402020 BCX0">er</span><span class="NormalTextRun SCXW243402020 BCX0"><span> </span>transcatheter aortic valve implant (TAVI) nearly halve</span><span class="NormalTextRun SCXW243402020 BCX0">s</span><span class="NormalTextRun SCXW243402020 BCX0"><span> </span>the risk of subclinical valve leaflet thrombosis<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">while<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">remaining</span><span class="NormalTextRun SCXW243402020 BCX0"><span> </span>noninferior for safety</span><span class="NormalTextRun SCXW243402020 BCX0">, according to<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">new trial findings.</span></span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" paraid="313595546" paraeid="{c03729c9-2e1f-486d-9602-5e95746373fb}{14}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW243402020 BCX0"><span class="NormalTextRun SCXW243402020 BCX0">Conclusions drawn from<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">the ACASA-TAVI<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">trial<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">challenge current recommendations that favor single antiplatelet therapy after TAVI in patients without another<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">indication</span><span class="NormalTextRun SCXW243402020 BCX0"><span> </span>for anticoagulation.</span></span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" paraid="747317614" paraeid="{c03729c9-2e1f-486d-9602-5e95746373fb}{16}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW243402020 BCX0"><span class="NormalTextRun SCXW243402020 BCX0">“</span><span class="NormalTextRun SCXW243402020 BCX0">In patients between the ages of 65 and 80 years old, a strategy of anticoagulation monotherapy after TAVI reduced subclinical leaflet thrombosis and was noninferior for bleeding, thromboembolic events, and death compared with ASA monotherapy</span><span class="NormalTextRun SCXW243402020 BCX0">.<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">These findings suggest that anticoagulation therapy can be beneficial after TAVI in selected patients</span><span class="NormalTextRun SCXW243402020 BCX0">,</span><span class="NormalTextRun SCXW243402020 BCX0">”</span><span> </span><span class="NormalTextRun SCXW243402020 BCX0">wrote the researchers, led by<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">Christopher S. Dodgson, MD,<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">from<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">the Department of Cardiology at Oslo University Hospital<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW243402020 BCX0">Rikshospitalet</span><span class="NormalTextRun SCXW243402020 BCX0">.</span></span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" paraid="170811866" paraeid="{c03729c9-2e1f-486d-9602-5e95746373fb}{18}"><strong><span class="NormalTextRun SCXW243402020 BCX0">Trial results detailed</span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" paraid="652301718" paraeid="{c03729c9-2e1f-486d-9602-5e95746373fb}{20}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW243402020 BCX0"><span class="NormalTextRun SCXW243402020 BCX0">T</span><span class="NormalTextRun SCXW243402020 BCX0">he ACASA-TAVI</span><span class="NormalTextRun SCXW243402020 BCX0"><span> </span>trial, presented at<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">a Hot Line session on S</span><span class="NormalTextRun SCXW243402020 BCX0">unday</span><span class="NormalTextRun SCXW243402020 BCX0"><span> </span>at the European Society of Cardiology (ESC) Congress 2026 in Munich, Germany,</span><span> </span><span class="NormalTextRun SCXW243402020 BCX0">included<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">360 patients aged 65 to 80 years who underwent TAVI for severe aortic stenosis</span><span class="NormalTextRun SCXW243402020 BCX0">.</span><span class="NormalTextRun SCXW243402020 BCX0"> </span></span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" paraid="1437728267" paraeid="{c03729c9-2e1f-486d-9602-5e95746373fb}{22}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW243402020 BCX0"><span class="NormalTextRun SCXW243402020 BCX0">A total of<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">180</span><span class="NormalTextRun SCXW243402020 BCX0"><span> </span>patients</span><span class="NormalTextRun SCXW243402020 BCX0"><span> </span>were assigned to 12 months of a factor Xa inhibitor non–vitamin K antagonist oral anticoagulant (NOAC) and 180 to acetylsalicylic acid (ASA; aspirin). </span></span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" paraid="380099194" paraeid="{c03729c9-2e1f-486d-9602-5e95746373fb}{24}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW243402020 BCX0"><span class="NormalTextRun SCXW243402020 BCX0">At 12 months,<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW243402020 BCX0">hypoattenuated</span><span class="NormalTextRun SCXW243402020 BCX0"><span> </span>leaflet thickening (HALT), a computed tomography marker of subclinical leaflet thrombosis, occurred in 16.2% of patients assigned to NOAC therapy versus 28.6% assigned to ASA, corresponding to a risk ratio of 0.55 (95%<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">confidence interval [</span><span class="NormalTextRun SCXW243402020 BCX0">CI</span><span class="NormalTextRun SCXW243402020 BCX0">]</span><span class="NormalTextRun SCXW243402020 BCX0">, 0.37–0.82; P=.004). </span></span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" paraid="393509277" paraeid="{c03729c9-2e1f-486d-9602-5e95746373fb}{26}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW243402020 BCX0"><span class="NormalTextRun SCXW243402020 BCX0">The primary safety end</span><span> </span><span class="NormalTextRun SCXW243402020 BCX0">point occurred<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW243402020 BCX0">in</span><span class="NormalTextRun SCXW243402020 BCX0"><span> </span>7.5% and 10.6%</span><span class="NormalTextRun SCXW243402020 BCX0"><span> </span>of patients</span><span class="NormalTextRun SCXW243402020 BCX0">, respectively, meeting the prespecified criterion for noninferiority.</span></span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" paraid="1643556939" paraeid="{c03729c9-2e1f-486d-9602-5e95746373fb}{28}"><strong><span class="NormalTextRun SCXW243402020 BCX0">Implications for practice</span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" paraid="1312074351" paraeid="{c03729c9-2e1f-486d-9602-5e95746373fb}{30}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW243402020 BCX0"><span class="NormalTextRun SCXW243402020 BCX0">Presenting the findings, which were also published in JAMA, study co-author Øyvind H. Lie,</span><span class="NormalTextRun SCXW243402020 BCX0"><span> </span>MD,</span><span class="NormalTextRun SCXW243402020 BCX0"><span> </span>from Oslo University Hospital<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW243402020 BCX0">Rikshospitalet</span><span class="NormalTextRun SCXW243402020 BCX0">, noted</span><span> </span><span class="NormalTextRun SCXW243402020 BCX0">that concerns about leaflet thrombosis<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">we</span><span class="NormalTextRun SCXW243402020 BCX0">re becoming increasingly important as TAVI expand</span><span class="NormalTextRun SCXW243402020 BCX0">ed</span><span class="NormalTextRun SCXW243402020 BCX0"><span> </span>to younger, lower-risk patients who may live longer with their bioprosthetic valves.<span> </span></span></span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" paraid="1836808569" paraeid="{c03729c9-2e1f-486d-9602-5e95746373fb}{32}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW243402020 BCX0"><span class="NormalTextRun SCXW243402020 BCX0">More severe grades of HALT were more common in the aspirin group, while there were no distinct differences between groups in most secondary end</span><span> </span><span class="NormalTextRun SCXW243402020 BCX0">points.</span></span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" paraid="161689914" paraeid="{c03729c9-2e1f-486d-9602-5e95746373fb}{34}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW243402020 BCX0"><span class="NormalTextRun SCXW243402020 BCX0">“These results add important knowledge<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW243402020 BCX0">on</span><span class="NormalTextRun SCXW243402020 BCX0"><span> </span>the role of NOAC monotherapy after TAVI</span><span class="NormalTextRun SCXW243402020 BCX0">.<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">The most recent clinical guidelines strongly discourage anticoagulation in patients without an independent<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">indication</span><span class="NormalTextRun SCXW243402020 BCX0">,</span><span class="NormalTextRun SCXW243402020 BCX0">”</span><span> </span><span class="NormalTextRun SCXW243402020 BCX0">wrote the researchers.</span></span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" paraid="1845305767" paraeid="{c03729c9-2e1f-486d-9602-5e95746373fb}{36}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW243402020 BCX0"><span class="NormalTextRun SCXW243402020 BCX0">The<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">researchers<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">cautioned that the results c</span><span class="NormalTextRun SCXW243402020 BCX0">ould not</span><span class="NormalTextRun SCXW243402020 BCX0"><span> </span>be directly extrapolated to older TAVI patients. </span></span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" paraid="233072225" paraeid="{c03729c9-2e1f-486d-9602-5e95746373fb}{38}"><span class="NormalTextRun SCXW243402020 BCX0">The open-label design could also have influenced treatment adherence and adverse-event reporting, while the lower-than-expected number of safety events resulted in a larger-than-planned noninferiority margin, limiting the strength of conclusions about safety.</span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" paraid="1813883810" paraeid="{c03729c9-2e1f-486d-9602-5e95746373fb}{40}"><strong><span class="NormalTextRun SCXW243402020 BCX0">Source:</span><span class="NormalTextRun SCXW243402020 BCX0"> </span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" paraid="104303453" paraeid="{c03729c9-2e1f-486d-9602-5e95746373fb}{42}"><span class="NormalTextRun SCXW243402020 BCX0">Dodgson CS, Herstad J, Kløve SF, et al. Anticoagulation Monotherapy vs Antiplatelet Monotherapy After Transcatheter Aortic Valve Implant: The ACASA-TAVI Randomized Clinical Trial.<span> </span></span><em><span class="NormalTextRun SCXW243402020 BCX0">JAMA</span></em><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW243402020 BCX0"><span class="NormalTextRun SCXW243402020 BCX0">.<span> </span></span><span class="NormalTextRun SCXW243402020 BCX0">(</span><span class="NormalTextRun SCXW243402020 BCX0">Article in<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW243402020 BCX0">Press</span><span class="NormalTextRun SCXW243402020 BCX0">)</span><span class="NormalTextRun SCXW243402020 BCX0">.</span></span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" lang="EN-US" paraid="1194667113" paraeid="{fab1a0ca-d638-44b1-ae65-d69419849b72}{151}"><strong><span class="NormalTextRun SCXW243402020 BCX0">Image Credit: European Society of Cardiology. Screenshot by Bailey G. Salimes, CRTonline.org.</span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW243402020 BCX0"> <p class="Paragraph SCXW243402020 BCX0" lang="EN-US" paraid="1094859762" paraeid="{fab1a0ca-d638-44b1-ae65-d69419849b72}{158}"><strong><span class="NormalTextRun SCXW243402020 BCX0">Image Caption: Øyvind H. Lie, MD, presents his research during a press conference at the European Society of Cardiology (ESC) Congress 2026 on Saturday in Munich, Germany.</span><span class="EOP Selected SCXW243402020 BCX0" data-ccp-props="{}"> </span></strong></p> </div>