TY - JOUR
T1 - Sex Differences in Transfemoral Transcatheter Aortic Valve Replacement
AU - Vlastra, Wieneke
AU - Chandrasekhar, Jaya
AU - García Del Blanco, Bruno
AU - Tchétché, Didier
AU - de Brito, Fabio S.
AU - Barbanti, Marco
AU - Kornowski, Ran
AU - Latib, Azeem
AU - D'Onofrio, Augusto
AU - Ribichini, Flavio
AU - Baan, Jan
AU - Tijssen, Jan G.P.
AU - Moreno, Raul
AU - Dumonteil, Nicolas
AU - Tarasoutchi, Flavio
AU - Sartori, Samantha
AU - D'Errigo, Paola
AU - Tarantini, Giuseppe
AU - Lunardi, Mattia
AU - Orvin, Katia
AU - Pagnesi, Matteo
AU - Berenguer, Alberto
AU - Modine, Thomas
AU - Dangas, George
AU - Mehran, Roxana
AU - Piek, Jan J.
AU - Delewi, Ronak
N1 - Publisher Copyright:
© 2019
PY - 2019/12/3
Y1 - 2019/12/3
N2 - Background: Transfemoral aortic valve replacement (TAVR) is a guideline-recommended treatment option for patients with severe aortic valve stenosis. Women and men present with different baseline characteristics, which may influence procedural outcomes. Objectives: This study sought to evaluate differences between women and men undergoing transfemoral TAVR across the globe during the last decade. Methods: The CENTER (Cerebrovascular EveNts in patients undergoing TranscathetER aortic valve implantation with balloon-expandable valves versus self-expandable valves)-collaboration was a global patient level dataset of patients undergoing transfemoral TAVR (N = 12,381) from 2007 to 2018. In this retrospective analysis, the study examined differences in baseline patient characteristics, 30-day stroke and mortality, and in-hospital outcomes between female and male patients. The study also assessed for temporal changes in outcomes and predictors for mortality per sex. Results: We included 58% (n = 7,120) female and 42% (n = 5,261) male patients. Women had higher prevalence of hypertension and glomerular filtration rate <30 ml/min/1.73 m2 but lower prevalence of all other traditional cardiovascular comorbidities. Both sexes had similar rates of 30-day stroke (2.3% vs. 2.5%; p = 0.53) and mortality (5.9% vs. 5.5%; p = 0.17). In contrast, women had a 50% higher risk of life-threatening or major bleeding (6.7% vs. 4.4%; p < 0.01). Over the study period, mortality rates decreased to a greater extent in men than in women (60% vs. 50% reduction; both p < 0.001), with no reductions in stroke rates over time. Conclusions: In this global collaboration, women and men had similar rates of 30-day mortality and stroke. However, women had higher rates of procedural life-threatening or major bleeding after TAVR. Between 2007 and 2018, mortality rates decreased to a greater extent in men than in women.
AB - Background: Transfemoral aortic valve replacement (TAVR) is a guideline-recommended treatment option for patients with severe aortic valve stenosis. Women and men present with different baseline characteristics, which may influence procedural outcomes. Objectives: This study sought to evaluate differences between women and men undergoing transfemoral TAVR across the globe during the last decade. Methods: The CENTER (Cerebrovascular EveNts in patients undergoing TranscathetER aortic valve implantation with balloon-expandable valves versus self-expandable valves)-collaboration was a global patient level dataset of patients undergoing transfemoral TAVR (N = 12,381) from 2007 to 2018. In this retrospective analysis, the study examined differences in baseline patient characteristics, 30-day stroke and mortality, and in-hospital outcomes between female and male patients. The study also assessed for temporal changes in outcomes and predictors for mortality per sex. Results: We included 58% (n = 7,120) female and 42% (n = 5,261) male patients. Women had higher prevalence of hypertension and glomerular filtration rate <30 ml/min/1.73 m2 but lower prevalence of all other traditional cardiovascular comorbidities. Both sexes had similar rates of 30-day stroke (2.3% vs. 2.5%; p = 0.53) and mortality (5.9% vs. 5.5%; p = 0.17). In contrast, women had a 50% higher risk of life-threatening or major bleeding (6.7% vs. 4.4%; p < 0.01). Over the study period, mortality rates decreased to a greater extent in men than in women (60% vs. 50% reduction; both p < 0.001), with no reductions in stroke rates over time. Conclusions: In this global collaboration, women and men had similar rates of 30-day mortality and stroke. However, women had higher rates of procedural life-threatening or major bleeding after TAVR. Between 2007 and 2018, mortality rates decreased to a greater extent in men than in women.
KW - outcome differences over time
KW - predictors of 30-day mortality
KW - sex differences
KW - transfemoral aortic valve implantation
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U2 - 10.1016/j.jacc.2019.09.015
DO - 10.1016/j.jacc.2019.09.015
M3 - Article
C2 - 31562908
AN - SCOPUS:85075042969
SN - 0735-1097
VL - 74
SP - 2758
EP - 2767
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 22
ER -