Background and Disease Burden
Non-vitamin K oral anticoagulants (NOACs) have become the preferred therapy over vitamin K antagonists (VKAs) in patients with nonvalvular atrial fibrillation (AF) due to their favorable safety profiles and ease of use. However, concerns persist regarding a potentially increased risk of major gastrointestinal bleeding (MGIB) with NOACs compared to VKAs. This risk is particularly critical in patients who have undergone transcatheter aortic valve replacement (TAVR), a population characterized by advanced age and frailty. MGIB episodes in this cohort often lead to worsened clinical outcomes, including an increased risk of mortality. Understanding the incidence, predictors, and consequences of MGIB in this high-risk group is essential to optimize anticoagulation strategies post-TAVR.
