Cardiologists share late-breaking TAVR data on first day of SCAI 2025
The opening day of SCAI 2025 Scientific Sessions, the annual meeting of the Society for Cardiovascular Angiography and Interventions (SCAI), included two late-breaking clinical trials focused on transcatheter aortic valve replacement (TAVR).
TAVR continues to gain momentum as a go-to treatment option for patients presenting with severe aortic stenosis. In fact, SCAI estimates that more than 100,500 TAVR procedures were performed in the United States in 2023 alone. These latest studies should help guide treatment decisions made by interventional cardiologists and other members of the heart team going forward.
Single antiplatelet therapy as ‘the standard of care’ after TAVR
One late-breaking study presented Thursday, May 1, examined the impact of recommending single antiplatelet therapy (SAPT) over dual antiplatelet therapy (DAPT) after patients undergo femoral TAVR. Researchers tracked data from more than 5,000 patients with a mean age of 81.5 years old. While more than 3,000 patients were discharged on SAPT, the remaining patients were discharged on DAPT. All data came from the multicenter Transfusion Requirements in Transcatheter Aortic Valve Implantation (TRITAVI) registry.
Lead author Francesco Pelliccia, MD, PhD, associate professor of cardiology at Sapienza University in Rome, Italy, presented her team’s findings. Overall, the group found that SAPT was associated with a significantly lower all-cause mortality rate after six months than DAPT (2.4% vs. 5.4%). SAPT was also linked to much lower rate of major bleeding events than DAPT (0.5% vs. 1.3%).
In addition, SAPT resulted in lower rates of cardiovascular mortality and non-cardiovascular mortality. DAPT was directly tied to a higher mortality risk for both male and female patients as well as those with and without a history of coronary artery disease (CAD).
“We were surprised to find that SAPT, rather than DAPT, after TAVR is associated with a better outcome, even in patients with CAD,” Pelliccia said in a statement. “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.”
Additional details about the session are available here.
Prosthesis-patient mismatch, but not mortality, more common for female patients
Another late-breaking study from Thursday focused on prosthesis-patient mismatch (PPM), one of the more common complications associated with TAVR procedures. Researchers examined retrospective data from more than 3,000 TAVR patients from 2012 to 2021. Approximately 44% of those patients were women.
Lead author Karim Al-Azizi, MD, an interventional cardiologist with Baylor Scott & White Health, presented his team’s findings. Overall, the predicted PPM rate was much higher for female patients than it was in men (26.2% vs. 18.2%), but the rates of measured PPM were much closer (26.7% vs. 24.1%). What stood out to the study’s authors was the fact this major disparity in predicted PPM did not appear to impact long-term patient survival in any way.
Predicted PPM and measured PPM were both much less likely when a self-expanding TAVR valve was used, he added. This is a key detail; researchers are always working to identify potential differences in patient outcomes between self-expanding and balloon-expandable TAVR valves.
“These findings highlight the importance of selecting the right valve based on a comprehensive, long-term treatment strategy—not just immediate echocardiographic metrics that may have little influence on long-term outcomes,” Al-Azizi said in a statement. “This is a timely study, as the SMART data was recently released, and there was no clinical difference between valve types nor an increased risk of needing valve re-interventions. This also underscores the critical need to evaluate TAVR outcomes specifically in women, where assumptions about risk and benefit may not hold true, and overlooking those differences could lead to poor long-term outcomes.”
Additional details about the session are available here.
SCAI 2025 Scientific Sessions is May 1-3 in Washington, D.C. More information is available on the SCAI website.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.