Clinical Research in Cardiology最新文献

{"title":"Clinical benefit and limitations of CT imaging substrate visualization technology for VT ablation.","authors":"Naoya Kataoka, Teruhiko Imamura","doi":"10.1007/s00392-024-02429-y","DOIUrl":"10.1007/s00392-024-02429-y","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"516"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140038800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epicardial ventricular tachycardia ablation: safety and efficacy of access and ablation using low-iodine content.","authors":"Julian Müller, Ivaylo Chakarov, Philipp Halbfass, Karin Nentwich, Artur Berkovitz, Kai Sonne, Sebastian Barth, Heiko Lehrmann, Thomas Deneke","doi":"10.1007/s00392-024-02378-6","DOIUrl":"10.1007/s00392-024-02378-6","url":null,"abstract":"<p><strong>Background: </strong>Epicardial ablation has become an integral part of the treatment of ventricular tachycardias (VT). This study reports the safety of epicardial access as well as the efficacy of epicardial ablation of structural heart disease in a tertiary single-center experience.</p><p><strong>Methods: </strong>Between January 2016 and February 2022, consecutive patients undergoing an epicardial access for VT ablation were included. Different puncture techniques and occurrence of epicardial access-related complications as well as the safety of ablation using non-ionic 5% dextrose in water (D5W) compared to standard 0.9% normal saline (NS) irrigation were analyzed. VT recurrence rates during a mean follow-up of 37 ± 23 months were reported.</p><p><strong>Results: </strong>In total, 197 patients undergoing a total of 239 procedures were included (59.8 ± 15.3 years, 86% males). A total of 154 patients (78%) had non-ischemic cardiomyopathies with a mean LVEF of 37 ± 14. Anterior-oriented epicardial access was aimed for in all cases and was successful in 217 (91%) of all procedures, whereas access was achieved in 19 procedures (8%) only using an inferior oriented access and in three procedures (1%) using surgical access due to severe adhesions or anatomical requirements. Overall epicardial puncture-related complications occurred in 18 (8%) of all procedures with minor pericardial bleeding in nine, pericardial tamponade in one, pneumothorax in five, pneumopericardium in one, and abdominal puncture in two cases. Presence of adhesions could be identified as the only independent predictor of epicardial access-related complications. D5W was used in 79 cases and regular 0.9% saline in 117 procedures. No differences were seen regarding acute ablation success or complications. During follow-up, 47% of all patients were free from any VTs (56% D5W vs. 40% NS; log-rank p = 0.747) and 92% of clinical VTs (98% D5W vs. 91% NS; log-rank p = 0.139).</p><p><strong>Conclusions: </strong>In this large single-centre experience, epicardial access and ablation were safe and feasible. Although long-term clinical VT recurrence rates were low, overall VT recurrences as well as mortality were high advocating for a highly experienced, interdisciplinary approach including intense management of underlying cardiac disease/heart failure. Routine usage of D5W was safe and associated with comparable short- or long-term clinical or overall VT freedom.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"462-474"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age- and sex-based normal reference ranges of the cardiac time intervals: the Copenhagen City Heart Study.","authors":"Alia Saed Alhakak, Flemming Javier Olsen, Kristoffer Grundtvig Skaarup, Mats Christian Højbjerg Lassen, Niklas Dyrby Johansen, Peter Godsk Jørgensen, Ulrik Abildgaard, Gorm Boje Jensen, Peter Schnohr, Peter Søgaard, Rasmus Møgelvang, Tor Biering-Sørensen","doi":"10.1007/s00392-023-02269-2","DOIUrl":"10.1007/s00392-023-02269-2","url":null,"abstract":"<p><strong>Background: </strong>Color tissue Doppler imaging (TDI) M-mode can be used to measure the cardiac time intervals including the isovolumic contraction time (IVCT), the left ventricular ejection time (LVET), the isovolumic relaxation time (IVRT), and the combination of all the cardiac time intervals in the myocardial performance index (MPI) defined as [(IVCT + IVRT)/LVET]. The aim of this study was to establish normal age- and sex-based reference ranges for the cardiac time intervals.</p><p><strong>Methods and results: </strong>A total of 1969 participants free of cardiovascular diseases and risk factors from the general population with limited age range underwent an echocardiographic examination including TDI. The median age was 46 years (25th-75th percentile: 33-58 years), and 61.5% were females. In the entire study population, the IVCT was observed to be 40 ± 10 ms [95% prediction interval (PI) 20-59 ms], the LVET 292 ± 23 ms (95% PI 248-336 ms), the IVRT 96 ± 19 ms (95% PI 59-134 ms) and MPI 0.47 ± 0.09 (95% PI 0.29-0.65). All the cardiac time intervals differed significantly between females and males. With increasing age, the IVCT increased in females, but not in males. The LVET did not change with age in both sexes, while the IVRT increased in both sexes with increasing age. Furthermore, we developed regression equations relating the heart rate to the cardiac time intervals and age- and sex-based normal reference ranges corrected for heart rate.</p><p><strong>Conclusion: </strong>In this study, we established normal age- and sex-based reference ranges for the cardiac time intervals. These normal reference ranges differed significantly with sex.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"430-442"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10256138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A screening for cerebral deoxygenation during VT ablations in patients with structural heart disease.","authors":"Julian Müller, Lena Koch, Philipp Halbfass, Karin Nentwich, Artur Berkovitz, Sebastian Barth, Christian Wächter, Heiko Lehrmann, Thomas Deneke","doi":"10.1007/s00392-024-02493-4","DOIUrl":"10.1007/s00392-024-02493-4","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing ventricular tachycardia (VT) ablation often present with structural heart disease (SHD) and reduced ejection fraction. Inducing VT by programmed electrical stimulation (PES) puts these patients at risk for hemodynamic instability and cerebral hypoperfusion.</p><p><strong>Objective: </strong>The present study screens for cerebral oxygen desaturation phases (ODPs) in patients undergoing VT ablation.</p><p><strong>Methods: </strong>Forty-seven patients (age 61 ± 14 years, 72% males) underwent ablation of sustained VT with simultaneous neuromonitoring using near-infrared spectroscopy (NIRS).</p><p><strong>Results: </strong>Analysis of NIRS signal identified ODPs in 29 patients (62%). ODPs were associated with a higher prevalence of ischemic heart disease (IHD) (45% vs. 11%, p = 0.024), previous VT episodes (n = 16 vs. 4, p = 0.018), and VTs inducible by PES (n = 2.4 vs. 1.2, p = 0.004). Patients with ODPs were more likely to be admitted to intensive care unit (ICU) (78% vs. 33%, p = 0.005) and had more in-hospital VT recurrences (24% vs. 0%, p = 0.034). No differences were observed in VT recurrence rates after hospital discharge (41.4% vs. 44.4%, p = 0.60) and left ventricular ejection fraction (34% vs. 38%, p = 0.567). IHD (OR: 32.837, p = 0.006), ICU admission (OR: 14.112, p = 0.013), and the number of VTs inducible at PES (OR: 2.705, p = 0.015) were independently associated with ODPs.</p><p><strong>Conclusions: </strong>This study registers episodes of cerebral hypoperfusion in 62% of patients undergoing VT ablation and identifies IHD and the number of VTs inducible at PES as possible risk factors for these episodes.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"481-491"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-hospital outcomes of catheter ablation in atrial arrhythmias: a nationwide analysis of 2,901 patients with adult congenital heart disease compared to 787,995 without.","authors":"Sebastian Grundmann, Klaus Kaier, Alexander Maier, Jonathan Rilinger, Johannes Steinfurt, Brigitte Stiller, Dirk Westermann, Constantin von Zur Mühlen, Markus Jäckel","doi":"10.1007/s00392-025-02614-7","DOIUrl":"10.1007/s00392-025-02614-7","url":null,"abstract":"<p><strong>Background: </strong>Advances in pediatric cardiology and congenital heart surgery have increased the adult population with congenital heart disease (CHD), now facing long-term complications like atrial arrhythmias. Given the limited data and safety concerns in this unique and vulnerable patient group, this study analyzes in-hospital outcomes of atrial catheter ablation in CHD patients versus non-CHD patients from a German nationwide real-world registry.</p><p><strong>Methods: </strong>Using health records, all atrial catheter ablation procedures in Germany from 2008 to 2021 were analyzed. After adjustment for confounders, safety performance endpoints were compared between patients with and without CHD.</p><p><strong>Results: </strong>From 2008 to 2021, 790,896 patients underwent right or left atrial catheter ablation in Germany. Of these, 1004 patients were classified as simple CHD, 1,054 patients as moderate CHD and 843 patients as complex CHD. Age at time of procedure was lower with increasing complexity of the CHD. Atypical atrial flutter (5.5% vs. 21.8%; p < 0.001) and other atrial tachycardias (21.2% vs. 42.2%; p < 0.001) occurred more often in patients with complex CHD compared to patients without. Combined ablation in both atria was more often performed in complex CHD. Despite higher complexity, in-hospital mortality (< 0.2%) and other investigated complications were rare. After adjustment for baseline characteristics, type of arrhythmia and ablation location, the relative risk for serious adverse events (combination of mortality, stroke, intracerebral bleeding or pericardiocentesis) did not show a significant difference for patients with CHD.</p><p><strong>Conclusion: </strong>Even in patients with CHD, complications are rare and after adjustment, no differences were identified concerning serious adverse events. Therefore, an ablation should not be generally avoided in patients with CHD due to concerns about complications although an individualized evaluation of the anatomy must be taken into account.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"507-515"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First successful epicardial ventricular tachycardia ablation in a patient with substernal implantable cardioverter defibrillator.","authors":"Nándor Szegedi, Ferenc Komlósi, Béla Merkely, László Gellér","doi":"10.1007/s00392-025-02634-3","DOIUrl":"10.1007/s00392-025-02634-3","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"517-519"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-specific outcomes in myocardial infarction: a dual-cohort analysis using clinical and real-world data.","authors":"Johannes Krefting, Christian Graesser, Sophie Novacek, Felix Voll, Aldo Moggio, Nils Krueger, Christian Friess, Marius Schwab, Frank Offenborn, Teresa Trenkwalder, Sebastian Kufner, Erion Xhepa, Michael Joner, Salvatore Cassese, Heribert Schunkert, Gjin Ndrepepa, Adnan Kastrati, Moritz von Scheidt, Thorsten Kessler, Hendrik B Sager","doi":"10.1007/s00392-025-02627-2","DOIUrl":"10.1007/s00392-025-02627-2","url":null,"abstract":"<p><strong>Background: </strong>Sex-related differences in symptoms, treatment, and outcomes in patients presenting with myocardial infarction have been reported but vary largely between studies. We sought to characterize sex differences in presentation and outcomes of patients with acute ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous intervention (PPCI).</p><p><strong>Methods and results: </strong>We included 1206 STEMI patients from a clinical cohort and 35,123 STEMI patients obtained from the German health insurance claims. Women, despite being older and thus having a worse cardiovascular risk profile, had greater myocardial salvage and smaller infarct size than men in all patients (median with [interquartile ranges (25th-75th percentiles), IQR]; salvage index: 0.58 [IQR: 0.32-0.91] in females vs. 0.47 [IQR: 0.23-0.77] in males, p < 0.0001; infarct size: 7.0% [IQR: 1.0-22.0%] in females vs. 11.0% [IQR: 3.0-23.0%] of the left ventricle in males, p = 0.002). Same results were shown for propensity score matched pairs (n = 242) (salvage index: 0.60 [IQR: 0.33-0.91] in females vs. 0.44 [IQR: 0.23-0.70] in males, p = 0.0002; infarct size: 7.0% [IQR: 1.0-23.0%] vs. 10% [IQR: 3.0-23.0%] of the left ventricle in males, p = 0.042). Furthermore, women showed a lower risk of 5-year mortality, assessed after propensity score matching, in the health insurance cohort (n = 19,404) (HR = 0.92 [95% CI 0.87-0.97], p = 0.002).</p><p><strong>Conclusions: </strong>In patients with STEMI, women appear to have better myocardial salvage and smaller infarct size after PPCI and a lower 5-year mortality compared with men, suggesting better ischemic tolerance in female patients.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in clinical features and 1-year outcomes of patients with heart failure and reduced, mildly reduced, and preserved ejection fraction in a contemporary cohort: is the clinical profile changing?","authors":"María Anguita-Gámez, Juan L Bonilla-Palomas, Alejandro Recio-Mayoral, Rafael González-Manzanares, Javier Muñiz-García, Nieves Romero-Rodríguez, Francisco J Elola-Somoza, Angel Cequier-Fillat, Luis Rodríguez-Padial, Manuel Anguita-Sánchez","doi":"10.1007/s00392-025-02632-5","DOIUrl":"https://doi.org/10.1007/s00392-025-02632-5","url":null,"abstract":"<p><strong>Aims: </strong>To analyze in a contemporary registry of heart failure (HF) patients followed in specialized HF units in Spain, the differences in clinical features, treatment, and 1-year outcomes in HF with reduced, mildly reduced, and preserved left ventricular ejection fraction.</p><p><strong>Methods and results: </strong>We analyzed data from the registry of the SEC-Excelente-IC quality accreditation program of the Spanish Society of Cardiology, with 1716 patients with HF included between 2019 and 2021 by 45 specialized HF units accredited by the SEC. Treatment and 1-year mortality, HF hospitalizations and decompensations of HF used were compared according to the type of HF. Of the 1,716 patients, 55.5% had HFrEF, 11.9% had HFmrEF, and 32.6% had HFpEF. HFpEF patients were older and had a higher proportion of women, atrial fibrillation, and hypertension. Sacubitril-valsartan and mineral receptor antagonists were used in greater proportion in HFrEF (56.5% and 73%, respectively, p < 0.001), but also in 10.3 and 33% in HFpEF. One-year mortality (17.3 vs 20.9 vs 15.6/100 persons-year; p = 0.321), 1-year HF hospitalizations (34.4 vs 29.5 vs 26.7/100 persons-year; p = 0.330), and 1-year decompensations of HF without hospitalization (13.1 vs 10.4 vs 11.1; p = 0.393) were similar for the 3 types of HF.</p><p><strong>Conclusion: </strong>In our contemporary cohort of real-life HF patients, slight differences were observed in clinical features and treatment between the 3 types of HF, but the prevalence of most of the major comorbidities and 1-year outcomes (mortality, hospitalizations and decompensations of HF) were similar in the 3 groups.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective comparison of temporal changes in myocardial function in women with Takotsubo versus anterior STEMI.","authors":"Sandeep Jha, Angela Poller, Aaron Shekka Espinosa, Linnea Molander, Valentyna Sevastianova, Rickard Zeijlon, Koen Simons, Emanuele Bobbio, Carlo Pirazzi, Andreas Martinsson, Tomas Mellberg, Thorsteinn Gudmundsson, Petronella Torild, Joakim Sundstrom, Erik Axel Andersson, Sigurdur Thorleifsson, Sabin Salahuddin, Ahmed Elmahdy, Tetiana Pylova, Araz Rawshani, Oskar Angeras, Truls Ramunddal, Kristofer Skoglund, Elmir Omerovic, Bjorn Redfors","doi":"10.1007/s00392-025-02633-4","DOIUrl":"https://doi.org/10.1007/s00392-025-02633-4","url":null,"abstract":"<p><strong>Background: </strong>Takotsubo syndrome (TS) and STEMI with timely reperfusion are both characterized by reversible acute myocardial dysfunction, often referred to as myocardial stunning. The natural course of cardiac functional recovery is incompletely understood in TS and STEMI. The aim of this study was to prospectively compare changes in cardiac function over the acute and subacute phases in women with TS versus anterior STEMI.</p><p><strong>Methods: </strong>The Stunning in Takotsubo versus Acute Myocardial Infarction (STAMI) study prospectively enrolled 61 women with TS and 41 women with STEMI. Echocardiography and blood sampling was performed within 4 h of admission and at 1, 2, 3, 7, 14, and 30 days after admission. The primary outcome was the proportion of reversible left ventricular akinesia (defined as extent of akinesia at baseline versus at 30 days) that resolved by 72 h. Secondary outcomes included LVEF, GLS, and TAPSE. Mixed effects linear regression or mixed effects tobit models with random intercepts were used to model echocardiographic parameters over time.</p><p><strong>Results: </strong>At 72 h 40.4% [95% CI 30.1%, 50.1%] of the reversible akinesia had resolved in women with TS, versus 54.7% [95% CI 38.3%, 72.0%] for STEMI (difference 14.3% [95% CI - 4.6%, 34.3%]). Time-course of recovery of LVEF and GLS was also similar in TS and STEMI. TAPSE was reduced in TS but normal in STEMI; and recovered in a similar timeframe as the left ventricular indices. In both TS and STEMI, considerable recovery of cardiac function occurred after 7 days.</p><p><strong>Conclusions: </strong>The time course of recovery of cardiac function is similar in TS and STEMI.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ID NCT04448639, https://clinicaltrials.gov/study/NCT04448639 .</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antithrombotic strategy following valve-in-valve transcatheter aortic valve replacement. A German Statutory Health Claims data analysis.","authors":"Sebastian Heyne, Christopher Hohmann, Sascha Macherey-Meyer, Max M Meertens, Elmar Kuhn, Ursula Marschall, Hendrik Wienemann, Victor Mauri, Matti Adam, Stephan Baldus, Samuel Lee","doi":"10.1007/s00392-025-02635-2","DOIUrl":"https://doi.org/10.1007/s00392-025-02635-2","url":null,"abstract":"<p><strong>Aims: </strong>Valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) procedures are increasingly used. Specific recommendations on antithrombotic strategies following ViV-TAVR are lacking. We aimed to assess the efficacy of different antithrombotic strategies following ViV-TAVR.</p><p><strong>Methods and results: </strong>We performed a retrospective analysis of German Statutory Health Claims data following ViV-TAVR stratified by antithrombotic strategies according to prescription within 90 days. Antithrombotic regimens included antiplatelet therapy (APT), direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs). The composite endpoint was all-cause mortality, stroke and/or systemic embolism (SSE) and mechanical complication of heart valve prosthesis at 12 months. Cox proportional hazard regression models were used to compare outcomes. In total, 908 patients between 2005 and 2022 were identified. Of these, 286 received DOACs, 99 received VKAs, 351 received APT exclusively and 172 had no prescription. The incidence of the composite endpoint was 20.8% in the APT group, 20.3% in the DOAC group and 25.3% in the VKA group which was not statistically significantly different. The rate of SSE in the acetylsalicylic acid (ASA) mono group was higher compared to the dual antiplatelet therapy (DAPT) group (27.3% vs. 12.4%, univariable HR 0.42, 95% CI [0.19, 0.95], p = 0.03).</p><p><strong>Conclusion: </strong>In this analysis of German Health Claims data, DOACs seemed to be a safe alternative to VKAs and APT. ASA monotherapy was associated with higher rates of SSE compared to DAPT. Given the high risk of bias of this retrospective analysis and the growing use of valve-in-valve procedures, randomized controlled trials are needed to confirm these findings.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}