Analysis From TRITAVI Registry Compares SAPT and DAPT After TAVR

May 1, 2025—The Society for Cardiovascular Angiography & Interventions (SCAI) announced that findings from an analysis of the Transfusion Requirements in Transcatheter Aortic Valve Implantation (TRITAVI) registry demonstrated that single antiplatelet therapy (SAPT) after transcatheter aortic valve replacement (TAVR) is associated with a significantly lower incidence of 6-month mortality and major bleeding risk compared to dual antiplatelet therapy (DAPT).

The late-breaking data were presented at the SCAI 2025 scientific sessions held May 1-3 in Washington, DC. The SCAI study abstract is available online here.

According to SCAI, investigators analyzed real-world data from the multicenter TRITAVI registry to determine the two therapies’ effect on mortality. The study was composed of 5,514 patients (age, 81.5 + 6.8 years; 48.4% males) discharged either on SAPT (n = 3,197) or on DAPT (n = 2,317).

As summarized in the SCAI press release, the study showed the 6-month all-cause mortality was 0.5% for SAPT versus 1.3% for DAPT and the major bleeding rate was 0.5% versus 1.3%. Additionally, the cardiovascular mortality rate for SAPT compared to DAPT was 1.3% versus 2.2%; and the noncardiovascular mortality rate was 1.1% versus 3.2%.

Sensitivity analyses confirmed that DAPT was significantly associated with mortality both in men (adjusted hazard ratio [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 (adjusted HR, 1.83; 95% CI, 1.01-3.35) and in patients without coronary artery disease (adjusted HR, 1.52; 95% CI, 1.04-2.20), stated the SCAI press release.

Francesco Pelliccia, MD, Associate Professor of Cardiology at Sapienza University in Rome, Italy, was lead author of the study.

“We were surprised to find that SAPT, rather than DAPT, after TAVR is associated with a better outcome, even in patients with coronary artery disease,” commented Dr. Pelliccia in the SCAI press release. “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.”