In a study published in the New England Journal of Medicine in April of 2020, 313 patients who were already on oral anticoagulation being treated with a trans-catheter aortic valve to receive either oral anticoagulation alone or with clopidogrel. The study was performed at 17 centers in Europe. The study showed a statistically significant increase in bleeding in the clopidogrel group (34.6%) vs. the anticoagulation alone group (21.7%). Most bleeding occurred at the femoral access site. There was no difference between groups for stroke or myocardial infarction. The authors concluded that clopidogrel was not needed in addition to anticoagulation after trans-catheter aortic valve replacement.