How Un-POPular Is Bleeding in Patients with TAVI?

This editorial discusses bleeding complications in patients undergoing transcatheter aortic-valve implantation (TAVI), focusing on the POPular TAVI trial (cohort B). The trial compared the safety of oral anticoagulants alone versus in combination with clopidogrel. The piece underscores the high bleeding risk associated with dual therapy and critiques methodological aspects such as endpoint classification and data interpretation. It also references prior trials and emerging studies, including ATLANTIS, highlighting the evolving understanding of optimal antithrombotic strategies in TAVI patients. The author advocates for regimens that balance thrombosis and bleeding risks and calls for future trials to be powered for hard clinical outcomes.

This editorial discusses bleeding complications in patients undergoing transcatheter aortic-valve implantation (TAVI), focusing on the POPular TAVI trial (cohort B). The trial compared the safety of oral anticoagulants alone versus in combination with clopidogrel. The piece underscores the high bleeding risk associated with dual therapy and critiques methodological aspects such as endpoint classification and data interpretation. It also references prior trials and emerging studies, including ATLANTIS, highlighting the evolving understanding of optimal antithrombotic strategies in TAVI patients. The author advocates for regimens that balance thrombosis and bleeding risks and calls for future trials to be powered for hard clinical outcomes.