Comparison of baseline characteristics and outcomes in men versus women with aortic stenosis undergoing transcatheter aortic valve implantation

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Item Type:	Article
Title:	Comparison of baseline characteristics and outcomes in men versus women with aortic stenosis undergoing transcatheter aortic valve implantation
Creators Name:	Sannino, A., Szerlip, M., Harrington, K., Schiattarella, G.G. and Grayburn, P.A.
Abstract:	Female gender has been linked to increased risk of adverse events after surgical aortic valve replacement; however, the evidence regarding the role of gender differences on clinical outcomes in patients who underwent transcatheter aortic valve implantation (TAVI) is still debated. This retrospective study included 910 consecutive patients with severe, symptomatic aortic stenosis who underwent TAVI in 2 institutions from January 2012 to July 2016. The primary end point was all-cause mortality at 1 year after TAVI in women versus men. Women had a higher incidence of in-hospital vascular complications (7.8% vs 4.1%) and major or life-threatening bleeding (4.0% vs 1.6%) than men. At 1 year, women showed a lower mortality rate than men (7.0% vs 12.7%, adjusted hazard ratio [HR] 0.42, 95% confidence interval [CI] [0.23 to 0.76], p = 0.004). When stratifying by specific subgroups of interest, the survival benefit in women persisted in (1) patients with a Society of Thoracic Surgery risk score ≤ 8 (adjusted HR 0.35, 95% CI [0.14 to 0.88], p = 0.026); (2) patients treated with first-generation devices (adjusted HR 0.46, 95% CI [0.24 to 0.86], p = 0.016); and (3) patients treated with balloon-expandable valves (adjusted HR 0.40, 95% CI [0.19 to 0.86], p = 0.019). In conclusion, in this large patient cohort, women had lower 1-year mortality after TAVI than men, particularly with an STS score ≤ 8, or treated with first-generation and balloon-expandable devices.
Keywords:	Age Distribution, Aortic Valve Insufficiency, Aortic Valve Stenosis, Artificial Pacemaker, Cohort Studies, Coronary Artery Disease, Heart Valve Prosthesis, Hypertension, Incidence, Mortality, Myocardial Revascularization, Postoperative Complications, Postoperative Hemorrhage, Proportional Hazards Models, Retrospective Studies, Severity of Illness Index, Sex Factors, Stroke Volume, Transcatheter Aortic Valve Replacement, Treatment Outcome
Source:	American Journal of Cardiology
ISSN:	0002-9149
Publisher:	Elsevier
Volume:	121
Number:	7
Page Range:	844-849
Date:	1 April 2018
Official Publication:	https://doi.org/10.1016/j.amjcard.2017.12.020
PubMed:	View item in PubMed

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