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Completed

NCT Number: NCT02735902

Anticoagulation Alone Versus Anticoagulation and Aspirin Following Transcatheter Aortic Valve Interventions (1:1)

The main objective of this study is to demonstrate that a single anticoagulant therapy is superior to a combination of anticoagulant and antiplatelet therapy on the net clinical benefit estimated at 12 months after a Transcatheter Aortic Valve Intervention (TAVI) according to BARC2 criteria (bleeding complications; Mehran et al 2011) and VARC 3 (other complications; Kappetein et al 2012)..

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 4

Primary location

CHRU de Montpellier - Hôpital Arnaud de Villeneuve, Montpellier, France

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About this study

The secondary objectives of this study are to evaluate the following at 3 months, 6 months and 12 months after TAVI in both groups:

  • Mortality (all causes).
  • Cardiovascular mortality.
  • The occurrence of myocardial infarction.
  • The occurrence of stroke.
  • The occurrence of valve thrombosis.
  • The occurrence of major bleeding (BARC ≥ 3).
  • The occurrence of minor bleeding (2 ≤ BARC <3).
  • Treatment compliance.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • The patient or his/her representative must have given free and informed consent and signed the consent
  • The patient must be insured or beneficiary of a health insurance plan
  • The patient is available for 12 months of follow-up
  • The patient underwent a successful transcutaneous implant procedure for an aortic valve
  • The patient required anticoagulant treatment (AVK or DOAC) excepted rivaroxaban the day of inclusion
  • The patient is stable on anticoagulant treatment

Exclusion criteria

  • The patient is participating in another study
  • The patient is in an exclusion period determined by a previous study
  • The patient or his/her representative refuses to sign the consent
  • It is impossible to correctly inform the patient or his/her representative
  • The patient is pregnant or breastfeeding
  • The patient has a contraindication (or an incompatible drug association) for a treatment used in this study
  • The patient had a coronary stent for less than 12 months
  • The patient does not require treatment with aspirin or any other antiplatelet agent
  • The patient has a history of aspirin allergy
  • High bleeding risk; such as platelets <50,000 / mm3 during screening, Hb <8.5 g / dL, history of intracranial hemorrhage or subdural hematoma, major surgery, parenchymal organ biopsy or severe trauma within 30 days before inclusion, active gastrointestinal ulcer in the last 3 months;
  • History of Stroke in the last 3 months;
  • Moderate or severe liver affection associated with coagulopathy
  • Active infectious endocarditis
  • Active tumor treated at the time of inclusion associated with expected survival less than one year
  • Not following countraindications specific to the molecules used fo the patients receiving DOAC

Treatment and study plan

Vitamin K antagonist or direct oral anticoagulant treatment

Drug

The Vitamin K antagonist or direct oral anticoagulant treatment will be administered to obtain an International Normalized Ratio between 2 and 3 as recommended if the treatment is AVK.

The Direct oral anticoagulant treatment : Apixaban 5 mg x2 or 2.5 mg X2, Edoxaban 30 ou 60 mg

Aspirin

Drug

Daily dose is between 75 mg and 100 mg.

Allergic reactions to aspirin may be observed in rare cases. In case of suspicion of allergy, treatment with aspirin is stopped.

Primary outcomes

  1. Composite outcome of the following events: death from any cause, myocardial infarction, stroke all causes, valve thrombosis and hemorrhage ≥ 2 as defined by the VARC 3 (Valve Academic Research Consortium scale).

    Time frame: Month 12

Secondary outcomes

  1. All cause death according to the VARC 3 criteria

    Time frame: month 1

  2. All cause death according to the VARC 3 criteria

    Time frame: month 3

  3. All cause death according to the VARC 3 criteria

    Time frame: month 6

  4. All cause death according to the VARC 3 criteria

    Time frame: month 12

  5. Death due to cardio-vascular causes according to the VARC 2 criteria

    Time frame: month 1

  6. Death due to cardio-vascular causes according to the VARC 3 criteria

    Time frame: month 3

  7. Death due to cardio-vascular causes according to the VARC 3 criteria

    Time frame: month 6

  8. Death due to cardio-vascular causes according to the VARC 3 criteria

    Time frame: month 12

  9. Myocardial infarction according to VARC 3 criteria

    Time frame: month 1

  10. Myocardial infarction according to VARC 3 criteria

    Time frame: month 3

  11. Myocardial infarction according to VARC 2 criteria

    Time frame: month 6

  12. Myocardial infarction according to VARC 3 criteria

    Time frame: month 12

  13. Stroke (all cause) according to the VARC 3 criteria

    Time frame: month 1

  14. Stroke (all cause) according to the VARC 3 criteria

    Time frame: month 3

  15. Stroke (all cause) according to the VARC 3 criteria

    Time frame: month 6

  16. Stroke (all cause) according to the VARC 3 criteria

    Time frame: month 12

  17. Valve thrombosis according to the VARC 3 criteria

    Time frame: Month 1

  18. Valve thrombosis according to the VARC 3 criteria

    Time frame: Month 3

  19. Valve thrombosis according to the VARC 3 criteria

    Time frame: Month 6

  20. Valve thrombosis according to the VARC 3 criteria

    Time frame: Month 12

  21. Major hemorrhage (BARC ≥ 3)

    Time frame: Month 1

  22. Major hemorrhage (BARC ≥ 3)

    Time frame: Month 3

  23. Major hemorrhage (BARC ≥ 3)

    Time frame: Month 6

  24. Major hemorrhage (BARC ≥ 3)

    Time frame: Month 12

  25. Minor hemorrhage (2 ≤ BARC < 3)

    Time frame: Month 1

  26. Minor hemorrhage (2 ≤ BARC < 3)

    Time frame: Month 3

  27. Minor hemorrhage (2 ≤ BARC < 3)

    Time frame: Month 6

  28. Minor hemorrhage (2 ≤ BARC < 3)

    Time frame: Month 12

  29. Observance / Modification of treatment (Questionnaire according to Girerd et al. 2001)

    Time frame: Month 1

  30. Observance / Modification of treatment (Questionnaire according to Girerd et al. 2001)

    Time frame: Month 3

  31. Observance / Modification of treatment (Questionnaire according to Girerd et al. 2001)

    Time frame: Month 6

  32. Observance / Modification of treatment (Questionnaire according to Girerd et al. 2001)

    Time frame: Month 12

Sponsors and collaborators

Lead sponsor

Centre Hospitalier Universitaire de Nīmes

Other

Collaborators

  • Medtronic

Registry information

Official study title

Anticoagulation Alone Versus Anticoagulation and Aspirin Following Transcatheter Aortic Valve Interventions - an Open, Multicenter Randomized Controlled Trial With Two Parallel Arms (1:1)

Acronym: AVATAR

Important dates

Study start
2017
Primary completion
2023
Study completion
2024
First posted
Apr 13, 2016
Registry last updated
Jul 24, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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