Effect of Sex on Mortality and Left Ventricular Remodeling After Transcatheter Aortic Valve Implantation

Shishido, Koki; Yamanaka, Futoshi; Ochiai, Tomoki; Moriyama, Noriaki; Yokoyama, Hiroaki; Yokota, Shohei; Noguchi, Kenichiro; Yashima, Fumiaki; Tada, Norio; Naganuma, Toru; Araki, Motoharu; Shirai, Shinichi; Ueno, Hiroshi; Mizutani, Kazuki; Tabata, Minoru; Takagi, Kensuke; Watanabe, Yusuke; Yamamoto, Masanori; Saïto, Shigeru; Hayashida, Kentaro

doi:10.1253/circj.cj-20-1095

Cited by 3 publications

(12 citation statements)

References 42 publications

(29 reference statements)

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“…A total of 28 16–43 studies were included that investigated the differences in outcomes between males and females undergoing TAVR. All included studies had a combined total of 156 275 patients with data collection dates ranging from 2004 to 2020.…”

Section: Resultsmentioning

confidence: 99%

“…One-year mortality ranged from 7.7% to 26.6% in males and 7.0% to 27.9% in females from 17 studies. 16,[18][19][20][21]23,24,26,29,[31][32][33][34]37,38,41,43 Five studies found significantly higher mortality, ranging from 12.7% to 25.9% in males and 7.0% to 19.0% (P = 0.004 to <0.001) in females. 29,[32][33][34]43 Pooled data of 1-year mortality were not significantly different between males and females with an OR of 1.13 (95% CI, 0.96-1.34; Z score, 1.48; P = 0.14).…”

Section: Mortality Ratesmentioning

confidence: 97%

“…16,[18][19][20][21]23,24,26,29,[31][32][33][34]37,38,41,43 Five studies found significantly higher mortality, ranging from 12.7% to 25.9% in males and 7.0% to 19.0% (P = 0.004 to <0.001) in females. 29,[32][33][34]43 Pooled data of 1-year mortality were not significantly different between males and females with an OR of 1.13 (95% CI, 0.96-1.34; Z score, 1.48; P = 0.14). Heterogeneity was substantial between studies (χ 2 = 65.99; I 2 = 76%; P < 0.00001; Fig.…”

Section: Mortality Ratesmentioning

confidence: 97%

“…Between 0.3% and 17.8% of males and 1.7% and 12.2% of females experienced mortality within 30 days postoperatively. 16,18,[20][21][22][24][25][26][28][29][30][31][32]34,[36][37][38][39]43 One study found significantly higher rates of mortality for males with 11.2% and 6.5% for females (P = 0.05), 26 and 2 studies found significantly higher mortality for females with 0.3%-6.5% for males and 2.4%-11.5% (P = 0.02-0.013) for females. 28,37 Pooled data did not demonstrate significant differences between males and females in 30-day mortality, resulting in an OR of 0.97 (95% CI, 0.87-1.07; Z score, 0.7; P = 0.48).…”

Section: Mortality Ratesmentioning

confidence: 99%

“…Sixteen studies provided MI data post-TAVR [17][18][19]21,[23][24][25]29,30,33,34,[37][38][39]41,42 with only one study 19 identifying significant differences between males and females. In this study, 2.1% of males and 0.3% of females had a post-TAVR MI (P = 0.03).…”

Section: Myocardial Infarctionmentioning

confidence: 99%

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Sex-Related Differences in Postoperative Outcomes After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis

Bozso

EL‐Andari

Kang

et al. 2022

Cardiology in Review

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Aortic stenosis is the most common valvular disease of the heart and is increasing in prevalence. Previous literature has found inferior outcomes for females undergoing surgical aortic valve replacement, while recent investigations have found equivalent or superior outcomes for females undergoing transcatheter aortic valve replacement (TAVR). PubMed and Medline were systematically searched for articles published from January 1, 2010, to April 30, 2021, for retrospective and prospective studies comparing outcomes between males and females undergoing TAVR. One thousand one hundred eighty titles and abstracts were screened, and 28 were included in this review. Risk of bias was assessed using questions derived from the ROBINS-I tool and previous literature. The data were compiled and analyzed using the RevMan 5.4 software. The results of this review confirm the previously published literature and have found rates of acute kidney injury (P = 0.05) and postoperative pacemaker insertion (P < 0.00001) favoring females and in-hospital mortality (P = 0.04), stroke (P < 0.00001), bleeding complications (P < 0.00001), and vascular complications (P < 0.00001) favoring males. The previously published literature has demonstrated consistently inferior outcomes for females undergoing heart valve surgery when compared to males. However, contemporary literature investigating sex differences after TAVR has found comparable outcomes for females. While the postoperative outcomes after surgical aortic valve replacement and TAVR are well established, the causal factors are still unidentified. Future studies utilizing matching based on preoperative characteristics and follow-up including collection of postoperative ventricular remodeling and prosthetic valve performance data will aid in elucidating the causal factors impacting outcomes for males and females after TAVR.

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Section: Resultsmentioning

confidence: 99%

Section: Mortality Ratesmentioning

confidence: 97%

Section: Mortality Ratesmentioning

confidence: 97%

Section: Mortality Ratesmentioning

confidence: 99%

Section: Myocardial Infarctionmentioning

confidence: 99%

See 3 more Smart Citations

Sex-Related Differences in Postoperative Outcomes After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis

Bozso

EL‐Andari

Kang

et al. 2022

Cardiology in Review

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Similar Left Ventricular Mass Regression But Different Outcomes Between Women and Men Undergoing Transcatheter Aortic Valve Implantation　― What Should We Learn From This Conflicting Result? ―

Yamano

Zen

Matoba

2021

Circ J

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cause diastolic dysfunction, adverse intramyocardial fibrosis, and even systolic dysfunction in a certain number of them, leading to heart failure. 1,3 Relief of LV pressure overload, either with surgical aortic valve replacement or transcatheter aortic valve implantation (TAVI), leads to substantial LV mass regression, which might be associated with clinical C hronic left ventricular (LV) pressure overload due to severe aortic stenosis (AS) leads to cardiac remodeling, of which LV hypertrophy (LVH) is the most important structural alteration. 1,2 Initially, LVH was thought to be a compensatory or adaptive process to maintain cardiac output in the face of elevated afterload by decreasing LV systolic wall stress according to the law of Laplace. However, in some patients, probably when the LV mass exceeds a certain threshold, maladaptive LVH may Article p ????The opinions expressed in this article are not necessarily those of the editors or of the Japanese Circulation Society.

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Gender-Dependent Association of Pulmonary Hypertension with Adverse Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement

Wang,

Yang,

Luo

et al. 2024

IJGM

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Effect of Sex on Mortality and Left Ventricular Remodeling After Transcatheter Aortic Valve Implantation

Cited by 3 publications

References 42 publications

Sex-Related Differences in Postoperative Outcomes After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis

Sex-Related Differences in Postoperative Outcomes After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis

Similar Left Ventricular Mass Regression But Different Outcomes Between Women and Men Undergoing Transcatheter Aortic Valve Implantation　― What Should We Learn From This Conflicting Result? ―

Gender-Dependent Association of Pulmonary Hypertension with Adverse Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement

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Effect of Sex on Mortality and Left Ventricular Remodeling After Transcatheter Aortic Valve Implantation

Cited by 3 publications

References 42 publications

Sex-Related Differences in Postoperative Outcomes After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis

Sex-Related Differences in Postoperative Outcomes After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis

Similar Left Ventricular Mass Regression But Different Outcomes Between Women and Men Undergoing Transcatheter Aortic Valve Implantation ― What Should We Learn From This Conflicting Result? ―

Gender-Dependent Association of Pulmonary Hypertension with Adverse Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement

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Product

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About

Similar Left Ventricular Mass Regression But Different Outcomes Between Women and Men Undergoing Transcatheter Aortic Valve Implantation　― What Should We Learn From This Conflicting Result? ―