Novel oral anticoagulants versus vitamin K antagonists in transcatheter aortic valve replacement treated patients-Patients' vulnerability still matters.

Abstract

Key points Current meta‐analysis suggests that outcomes with novel oral anticoagulants (NOACs) do not significantly differ compared to vitamin K antagonists (VKAs) after transcatheter aortic valve replacement (TAVR) in patients with atrial fibrillation (AF), in particular, NOACs failed to demonstrate a better safety profile than VKAs in this clinical setting.Accordingly, the choice between NOACs and VKAs in AF patients after TAVR is left to clinical judgment.Future large‐scale clinical trials are warranted to establish a clinically superior anticoagulant regime in this clinical setting, based on risk profile and need for concomitant antiplatelet therapy.