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Daniel Victor Ortigoza: New Evidence from ATLANTIS-4D-CT on Apixaban and Subclinical Valve Thrombosis
Jul 8, 2026, 05:39

Daniel Victor Ortigoza: New Evidence from ATLANTIS-4D-CT on Apixaban and Subclinical Valve Thrombosis

Daniel Victor Ortigoza, Vice Chair of the Argentine Federation of Cardiology’s Cardio-Oncology Committee, shared on LinkedIn about a recent article by Gilles Montalescot et al, published in JACC, adding:

”Apixaban and Valve Thrombosis After Transcatheter Aortic Valve Replacement: The ATLANTIS-4D-CT Randomized Clinical Trial Substudy. Gilles Montalescot, MD, PHD, et al. J Am Coll Cardiol Intv 2022;15:1794–1804)

A prospective, controlled, open-label, randomized clinical trial in post-TAVR patients comparing apixaban versus standard treatment, evaluated using 4D CT and cardiac Doppler echocardiography.

762 patients evaluated with 4D CT and then randomized 1:1

The aim was to determine whether the DOAC prevents the formation of small thrombi on the implanted valve.

Apixaban reduced subclinical thrombosis (8.9% vs. 13%) but did not demonstrate significant clinical improvements (death, myocardial infarction, or stroke)

Classification of the degree of thrombosis detected by 4D C:

HALT – hypoattenuated leaflet thickening
RLM – reduced leaflet motion.”

Title: Apixaban and Valve Thrombosis After Transcatheter Aortic Valve Replacement: The ATLANTIS-4D-CT Randomized Clinical Trial Substudy

Authors: Gilles Montalescot, Alban Redheuil, Flavien Vincent, Steffen Desch, Mauro De Benedictis, Hélène Eltchaninoff, Dietmar Trenk, Jean-Michel Serfaty, Etienne Charpentier, Khaoula Bouazizi, Mikael Prigent, Paul Guedeney, Tomy Salloum, Sergio Berti, Angel Cequier, Thierry Lefèvre, Pascal Leprince, Johanne Silvain, Eric Van Belle, Franz-Josef Neumann, Jean-Jacques Portal, Eric Vicaut, Jean-Philippe Collet

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