The influence of gender on outcomes following transcatheter aortic valve implantation. in Frontiers in cardiovascular medicine / Front Cardiovasc Med. 2024 Jul 17;11:1417430. doi: 10.3389/fcvm.2024.1417430. eCollection 2024.
2024
AO Ordine Mauriziano
Tipo pubblicazione
Journal Article
Autori/Collaboratori (8)Vedi tutti...
Centofanti P
Department of Cardiac Surgery, Azienda Ospedaliera Ordine Mauriziano di Torino, Turin, Italy.
Buono G
Department of Cardiovascular Anesthesia and Intensive Care, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy.
Pietropaolo C
Department of Cardiovascular Anesthesia and Intensive Care, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy.
et alii...
Abstract
OBJECTIVES: This study aimed to compare gender-related differences in short- and long-term outcomes after transcatheter aortic valve implantation. METHODS: Patients who underwent transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) from September 2017 to December 2022 were enrolled. The primary endpoint was 5-year all-cause mortality. The secondary endpoints were 30-day mortality and the incidence of post-procedural complication. Patients were separated according to gender before statistical analysis. To compare patients with similar baseline characteristics, we performed a propensity matching. RESULTS: A total of 704 patients [females, 361 (51.3%); males, 343 (48.7%)] were enrolled. Compared to women, men had a higher incidence of smoking (40.5% vs. 14.7%, p?0.001), diabetes (32.9% vs. 25.1%, p?0.025), peripheral artery disease (35.8% vs. 18.3%, p?0.001), and previous cardiac surgery (13.7% vs. 7.2%, p?=?0.006) and a lower ejection fraction [56.6 (9.3) vs. 59.8 (7.5), p?=?0.046]. Female patients were frailer at the time of the procedure [poor mobility rate, 26% vs. 11.7%, p?0.001; CCI (Charlson comorbidity index) 2.4 (0.67) vs. 2.32 (0.63), p?=?0.04]. Despite these different risk profiles, no significant differences were reported in terms of post-procedural outcomes and long-term survival. Propensity score matching resulted in a good match of 204 patients in each group (57.9% of the entire study population). In the matched cohort, men had a significantly higher incidence of new pacemaker implantation compared to women [33 (16.2%) vs. 18 (8.8%)]. The Kaplan-Meier 5-year survival estimate was 82.4% for women and 72.1% for men, p?=?0.038. CONCLUSIONS: Female gender could be considered as a predictor of better outcomes after TAVI.
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PMID : 39087077
DOI : 10.3389/fcvm.2024.1417430
Keywords
transcatheter aortic valve implantation; sex differences; gender differences; aortic stenosis; TAVI;