Global Study Comparing a rivAroxaban-based Antithrombotic Strategy to an antipLatelet-based Strategy After Transcatheter aortIc vaLve rEplacement to Optimize Clinical Outcomes

NCT ID: NCT02556203

Last Updated: 2020-01-13

Study Results

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

1653 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-12-16

Study Completion Date

2018-11-27

Brief Summary

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To assess whether a rivaroxaban-based anticoagulation strategy, following successful TAVR, compared to an antiplatelet-based strategy, is superior in reducing death or first thromboembolic events (DTE).

To assess the primary bleeding events (PBE) of the rivaroxaban-based strategy compared to an antiplatelet-based strategy, following TAVR.

Detailed Description

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Conditions

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Transcatheter Aortic Valve Replacement

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Rivaroxaban (Xarelto, BAY59-7939)

Subjects were treated with Rivaroxaban (10mg once-daily) and ASA (75-100mg once-daily) within first 90 days after randomization. After 90 days, ASA was discontinued and rivaroxaban (10mg once-daily) was to be continued alone. In the event of NOAF (New Onset of Atrial Fibrillation), subjects should be switched to rivaroxaban (20/15mg once-daily) and ASA (75-100mg once-daily) within first 90 days. After 90 days, ASA was discontinued and rivaroxaban (20/15mg once-daily) was to be continued alone.

Group Type EXPERIMENTAL

Rivaroxaban (Xarelto, BAY59-7939)

Intervention Type DRUG

10mg OD (once-daily)

Acetylsalicylic Acid (ASA)

Intervention Type DRUG

75-100mg OD

Rivaroxaban (Xarelto, BAY59-7939)

Intervention Type DRUG

In case of NOAF, 20/15 mg OD (once-daily)

Antiplatelet

Subjects were treated with clopidogrel (75mg once-daily) and ASA (75-100mg once-daily) within first 90 days after randomization. After 90 days, clopidogrel was discontinued and ASA (75-100mg once-daily) was to be continued alone. In the event of NOAF, subjects should start treatment of open-label VKA to target INR 2 to 3 (according to guidelines) and ASA (75-100mg once-daily) within first 90 days. After 90 days, ASA was discontinued and VKA was to be continued alone.

Group Type ACTIVE_COMPARATOR

Acetylsalicylic Acid (ASA)

Intervention Type DRUG

75-100mg OD

Clopidogrel

Intervention Type DRUG

75mg OD

Vitamin K antagonist (VKA)

Intervention Type DRUG

In case of NOAF, Open-label VKA therapy to target international normalized ratio (INR) 2-3, according to guidelines

Interventions

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Rivaroxaban (Xarelto, BAY59-7939)

10mg OD (once-daily)

Intervention Type DRUG

Acetylsalicylic Acid (ASA)

75-100mg OD

Intervention Type DRUG

Clopidogrel

75mg OD

Intervention Type DRUG

Rivaroxaban (Xarelto, BAY59-7939)

In case of NOAF, 20/15 mg OD (once-daily)

Intervention Type DRUG

Vitamin K antagonist (VKA)

In case of NOAF, Open-label VKA therapy to target international normalized ratio (INR) 2-3, according to guidelines

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Successful TAVR (Transcatheter Aortic Valve Replacement) of an aortic valve stenosis (either native or valve-in-valve)

* By iliofemoral or subclavian access
* With any approved/marketed device

Exclusion Criteria

* Atrial fibrillation (AF), current or previous, with an ongoing indication for oral anticoagulant treatment
* Any other indication for continued treatment with any oral anticoagulant (OAC)
* Known bleeding diathesis (such as but not limited to active internal bleeding, clinically significant bleeding, platelet count ≤ 50,000/mm3 at screening, hemoglobin level \< 8.5 g/dL, active peptic ulcer or known gastrointestinal (GI) bleeding, history of intracranial hemorrhage or subdural hematoma)
* Any ongoing absolute indication for dual antiplatelet therapy (DAPT) at time of screening that is unrelated to the TAVR procedure
* Clinically overt stroke within the last 3 months
* Planned coronary or vascular intervention or major surgery
* Severe renal impairment (eGFR \< 30 mL/min/1.73 m2) or on dialysis, or post-TAVR unresolved acute kidney injury with renal dysfunction stage 2 or higher
* Moderate and severe hepatic impairment (Child-Pugh Class B or C) or any hepatic disease associated with coagulopathy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Janssen Research & Development, LLC

INDUSTRY

Sponsor Role collaborator

Bayer

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Bayer Study Director

Role: STUDY_DIRECTOR

Bayer

Locations

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Los Angeles, California, United States

Site Status

Washington D.C., District of Columbia, United States

Site Status

Clearwater, Florida, United States

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Jacksonville, Florida, United States

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Miami, Florida, United States

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Atlanta, Georgia, United States

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Chicago, Illinois, United States

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Evanston, Illinois, United States

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West Des Moines, Iowa, United States

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Baltimore, Maryland, United States

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Boston, Massachusetts, United States

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Detroit, Michigan, United States

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Minneapolis, Minnesota, United States

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Kansas City, Missouri, United States

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Morristown, New Jersey, United States

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Manhasset, New York, United States

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New York, New York, United States

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Roslyn, New York, United States

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Winston-Salem, North Carolina, United States

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Cincinnati, Ohio, United States

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Cleveland, Ohio, United States

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Philadelphia, Pennsylvania, United States

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Wilkes-Barre, Pennsylvania, United States

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Houston, Texas, United States

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Houston, Texas, United States

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Plano, Texas, United States

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Temple, Texas, United States

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Burlington, Vermont, United States

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Charlottesville, Virginia, United States

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Falls Church, Virginia, United States

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Tacoma, Washington, United States

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Graz, Styria, Austria

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Linz, Upper Austria, Austria

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Wels, Upper Austria, Austria

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Salzburg, , Austria

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Vienna, , Austria

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Vienna, , Austria

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Vienna, , Austria

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Genk, , Belgium

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Hasselt, , Belgium

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Liège, , Belgium

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Edmonton, Alberta, Canada

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Vancouver, British Columbia, Canada

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Victoria, British Columbia, Canada

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Winnipeg, Manitoba, Canada

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Halifax, Nova Scotia, Canada

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Newmarket, Ontario, Canada

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Toronto, Ontario, Canada

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Toronto, Ontario, Canada

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Montreal, Quebec, Canada

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Brno, , Czechia

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Prague, , Czechia

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Prague, , Czechia

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Aarhus N, , Denmark

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Copenhagen, , Denmark

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Odense C, , Denmark

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Angers, , France

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Brest, , France

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Chambray-lès-Tours, , France

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Lille, , France

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Paris, , France

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Paris, , France

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Toulouse, , France

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Freiburg im Breisgau, Baden-Wurttemberg, Germany

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Konstanz, Baden-Wurttemberg, Germany

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Lahr, Baden-Wurttemberg, Germany

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Tübingen, Baden-Wurttemberg, Germany

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Ulm, Baden-Wurttemberg, Germany

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Bad Neustadt an der Saale, Bavaria, Germany

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Erlangen, Bavaria, Germany

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München, Bavaria, Germany

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München, Bavaria, Germany

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München, Bavaria, Germany

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Regensburg, Bavaria, Germany

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Bad Nauheim, Hesse, Germany

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Frankfurt am Main, Hesse, Germany

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Fulda, Hesse, Germany

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Rotenburg A.d. Fulda, Hesse, Germany

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Hanover, Lower Saxony, Germany

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Aachen, North Rhine-Westphalia, Germany

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Bonn, North Rhine-Westphalia, Germany

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Cologne, North Rhine-Westphalia, Germany

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Dortmund, North Rhine-Westphalia, Germany

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Düsseldorf, North Rhine-Westphalia, Germany

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Krefeld, North Rhine-Westphalia, Germany

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Neuss, North Rhine-Westphalia, Germany

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Mainz, Rhineland-Palatinate, Germany

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Homburg, Saarland, Germany

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Leipzig, Saxony, Germany

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Magdeburg, Saxony-Anhalt, Germany

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Bad Segeberg, Schleswig-Holstein, Germany

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Kiel, Schleswig-Holstein, Germany

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Bad Berka, Thuringia, Germany

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Berlin, , Germany

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Berlin, , Germany

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Berlin, , Germany

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Bremen, , Germany

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Hamburg, , Germany

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Bergamo, Lombardy, Italy

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Milan, Lombardy, Italy

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Milan, Lombardy, Italy

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Milan, Lombardy, Italy

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Catania, Sicily, Italy

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Pisa, Tuscany, Italy

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Padua, Veneto, Italy

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Amsterdam, , Netherlands

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Breda, , Netherlands

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Rotterdam, , Netherlands

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Bergen, , Norway

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Oslo, , Norway

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Tromsø, , Norway

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Bielsko-Biala, , Poland

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Warsaw, , Poland

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Warsaw, , Poland

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Seoul, , South Korea

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Seoul, , South Korea

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Seoul, , South Korea

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Seoul, , South Korea

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L'Hospitalet de Llobregat, Barcelona, Spain

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Oviedo, Principality of Asturias, Spain

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Barcelona, , Spain

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Madrid, , Spain

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Málaga, , Spain

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Uppsala, , Sweden

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Basel, Canton of Basel-City, Switzerland

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Lugano, Canton Ticino, Switzerland

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Bern, , Switzerland

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Lucerne, , Switzerland

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Zurich, , Switzerland

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Brighton, East Sussex, United Kingdom

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Southampton, Hampshire, United Kingdom

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Blackpool, Lancashire, United Kingdom

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Leicester, Leicestershire, United Kingdom

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Belfast, North Ireland, United Kingdom

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Newcastle upon Tyne, Tyne and Wear, United Kingdom

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Leeds, West Yorkshire, United Kingdom

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Edinburgh, , United Kingdom

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London, , United Kingdom

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London, , United Kingdom

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Oxford, , United Kingdom

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Countries

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United States Austria Belgium Canada Czechia Denmark France Germany Italy Netherlands Norway Poland South Korea Spain Sweden Switzerland United Kingdom

References

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Okuno T, Dangas GD, Hengstenberg C, Sartori S, Herrmann HC, de Winter R, Gilard M, Tchetche D, Mollmann H, Makkar RR, Baldus S, De Backer O, Bendz B, Kini A, von Lewinski D, Mack M, Moreno R, Schafer U, Wohrle J, Seeger J, Snyder C, Nicolas J, Tijssen JGP, Welsh RC, Vranckx P, Valgimigli M, Mehran R, Kapadia S, Sondergaard L, Windecker S. Two-year clinical outcomes after successful transcatheter aortic valve implantation with balloon-expandable versus self-expanding valves: A subanalysis of the GALILEO trial. Catheter Cardiovasc Interv. 2022 Oct;100(4):636-645. doi: 10.1002/ccd.30370. Epub 2022 Aug 30.

Reference Type DERIVED
PMID: 36040717 (View on PubMed)

Wohrle J, Gilard M, Didier R, Kini A, Tavenier AH, Tijssen JGP, Sartori S, Snyder C, Nicolas J, Seeger J, Landmesser U, Tarantini G, Asgar A, Mollmann H, Thiele H, Capranzano P, Reimers B, Stefanini G, Moreno R, Petronio AS, Mikhail G, Kapadia S, Hildick-Smith D, Hengstenberg C, Mehran R, Windecker S, Dangas GD; GALILEO Investigator. Outcomes After Transcatheter Aortic Valve Implantation in Men Versus Women. Am J Cardiol. 2022 Oct 1;180:108-115. doi: 10.1016/j.amjcard.2022.06.035. Epub 2022 Aug 4.

Reference Type DERIVED
PMID: 35934563 (View on PubMed)

Dangas GD, Tijssen JGP, Wohrle J, Sondergaard L, Gilard M, Mollmann H, Makkar RR, Herrmann HC, Giustino G, Baldus S, De Backer O, Guimaraes AHC, Gullestad L, Kini A, von Lewinski D, Mack M, Moreno R, Schafer U, Seeger J, Tchetche D, Thomitzek K, Valgimigli M, Vranckx P, Welsh RC, Wildgoose P, Volkl AA, Zazula A, van Amsterdam RGM, Mehran R, Windecker S; GALILEO Investigators. A Controlled Trial of Rivaroxaban after Transcatheter Aortic-Valve Replacement. N Engl J Med. 2020 Jan 9;382(2):120-129. doi: 10.1056/NEJMoa1911425. Epub 2019 Nov 16.

Reference Type DERIVED
PMID: 31733180 (View on PubMed)

Piayda K, Zeus T, Sievert H, Kelm M, Polzin A. Subclinical leaflet thrombosis. Lancet. 2018 Mar 10;391(10124):937-938. doi: 10.1016/S0140-6736(18)30534-8. No abstract available.

Reference Type DERIVED
PMID: 29536857 (View on PubMed)

Windecker S, Tijssen J, Giustino G, Guimaraes AH, Mehran R, Valgimigli M, Vranckx P, Welsh RC, Baber U, van Es GA, Wildgoose P, Volkl AA, Zazula A, Thomitzek K, Hemmrich M, Dangas GD. Trial design: Rivaroxaban for the prevention of major cardiovascular events after transcatheter aortic valve replacement: Rationale and design of the GALILEO study. Am Heart J. 2017 Feb;184:81-87. doi: 10.1016/j.ahj.2016.10.017. Epub 2016 Oct 31.

Reference Type DERIVED
PMID: 27892890 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Related Links

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http://clinicaltrials.bayer.com/

Click here to find results for studies related to Bayer products

Other Identifiers

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2015-001975-30

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

17938

Identifier Type: -

Identifier Source: org_study_id

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