TRITAVI Registry: Single Antiplatelet Therapy Reduced Risk of Mortality and Major Bleeding in Patients Undergoing TAVR by Half
Society for Cardiovascular Angiography & Interventions (SCAI) News
WASHINGTON, D.C. — Findings from the Transfusion Requirements in Transcatheter Aortic Valve Implantation (TRITAVI) registry demonstrate that single antiplatelet therapy (SAPT) after transcatheter aortic valve replacement (TAVR) is associated with a significantly lower incidence of six-month mortality and major bleeding risk compared to dual antiplatelet therapy (DAPT). The late-breaking data were presented May 1 at the Society for Cardiovascular Angiography & Interventions (SCAI) 2025 Scientific Sessions.
The current standard of care following TAVR is SAPT, which involves the use of only one antiplatelet drug, such as aspirin, to prevent blood clot formation. Traditionally, SAPT is used compared to DAPT, mainly based on the lower bleeding risk; however, the data on mortality are inconclusive. This insight is increasingly important as the number of TAVR procedures performed has steadily increased, making it the most common procedure for patients with aortic stenosis.
Researchers analyzed real-world data from the multicenter TRITAVI registry to determine the differing therapies’ effect on mortality. 5,514 patients (81.5+6.8 years, 48.4% males) were discharged either on SAPT (n=3,197) or DAPT (n=2,317).
The all-cause mortality and rate of major bleeding at six months were significantly lower in the SAPT group as compared with the DAPT group (2.4% vs 5.4%, and 0.5% vs. 1.3%, respectively). SAPT was associated with lower cardiovascular and non-cardiovascular mortality, as compared to DAPT (1.3% vs 2.2% and 1.1% vs 3.2%, respectively). Sensitivity analyses confirmed that DAPT was significantly associated with mortality both in men (adjusted HR: 2.08; 95% CI: 1.32-3.30) and in women (adjusted HR: 1.53; 95% CI: 1.03-2.29), as well as in patients with coronary artery disease (CAD) (adjusted HR: 1.83; 95% CI: 1.01-3.35) and in patients without CAD (adjusted HR: 1.52; 95% CI: 1.04-2.20).
“We were surprised to find that SAPT, rather than DAPT, after TAVR is associated with a better outcome, even in patients with CAD,” said Francesco Pelliccia, MD, PhD, Associate Professor of Cardiology at Sapienza University in Rome, Italy, and lead author of the study. “The results, for the first time, provide clinicians more information on how to treat their patients who are at high risk for bleeding and provide evidence that SAPT should be considered the standard of care in all patients undergoing TAVR.
Session Details:
- “Antiplatelet Therapy and All-cause Mortality after Transcatheter Aortic Valve Replacement – Insights from the TRITAVI Registry”
- Thursday, May 1, 2025; 10:47-10:55 AM ET
- Walter E. Washington Convention Center, Exhibit Hall D
About SCAI Scientific Sessions 2025
The SCAI Scientific Sessions annual meeting convenes 2,000 of the world’s premier clinicians, scientists, researchers, and innovators in the field of interventional cardiology and endovascular medicine. With 500+ faculty and hundreds of abstracts, experts in the field work together to share the latest clinical data, procedural guidance, and advanced expertise. Highlights will include live cases, featured clinical research, new SCAI clinical documents, case-based learning, and keynote speakers. For more information, visit SCAI 2025 Scientific Sessions | SCAI.
About Society for Cardiovascular Angiography & Interventions (SCAI)
The Society for Cardiovascular Angiography & Interventions, established in 1978, stands as the primary nonprofit medical society dedicated to representing invasive and interventional cardiology. SCAI's mission is to guide the global interventional cardiovascular community by fostering education, advocacy, research, and upholding standards for quality patient care. For more than 40 years, SCAI has exemplified professional excellence and innovation worldwide, cultivating a reputable community of over 5,000 members committed to advancing medical science and providing life-saving care for individuals, both adults and children, affected by cardiovascular disease. For more information, visit SCAI.ORG.
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