ESC Congress 2024 — No benefit of continuing oral anticoagulation during TAVI procedure. 

Investigator, Dr Dirk-Jan van Ginkel (St Antonius Hospital, NL) joins us to discuss the result of the POPular PAUSE TAVI trial (NCT04437303; St Antonius Hospital). Presented for the first time at ESC 2024, this multicenter, randomized, open-label clinical trial compared the safety and efficacy of continuous versus interrupted oral anticoagulant (OAC) therapy during transcatheter aortic valve implantation (TAVI). A total of 858 patients were randomized to either continued or interrupted OAC treatment. The primary outcome was a composite of cardiovascular death, any stroke, myocardial infarction, major vascular complications, and VARC-3 defined type 2-4 bleeding events at 30 days post-TAVI.

Findings show that in patients undergoing TAVI with an indication for oral anticoagulation, periprocedural continuation was not found to be noninferior to interruption of oral anticoagulation during TAVI.

Interview Questions:

1. What is the background to the POPular PAUSE TAVI trial?
2. What was the study design, eligibility criteria and outcome measures?
3. What are the findings?
4. Are there any patient subgroups that benefit more from continuous OAC?
5. What are the take-home messages for practice? (+Should these findings influence guidelines?)
6. What are the next steps?

Recorded on-site at ESC Congress 2024, London.  

Editors: Jordan Rance and Mirjam Boros. 
Videographers: Mike Knight, Dan Brent, Oliver Miles, Tom Green, David-Ben-Harosh.  

Support: This is an independent interview produced by Radcliffe Cardiology.