Sex and Transcatheter Aortic Valve Implantation: Impact of Female Sex on Clinical Outcomes

Laricchia, Alessandra; Bellini, Barbara; Romano, Vittorio; Khawaja, Saud; Montorfano, Matteo; Chieffo, Alaide

doi:10.15420/icr.2019.07.r1

Cited by 9 publications

(11 citation statements)

References 48 publications

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“…Theories behind this include that females are more likely to be older and frailer at presentation; have higher pulmonary pressures and more concomitant mitral valve disease ( 26 ); and that AS may be more common in females, related to longer life expectancy as well as smaller aortic root dimensions ( 27 ). However, males have a much higher preponderance of cardiovascular risk factors (which are mostly shared with AS) and have a lower left ventricular ejection fraction at presentation ( 28 ). Females present later into the disease course with more insidious symptoms; thus AS incidence, and therefore mortality, may be under-represented in this group ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

Trends in Mortality From Aortic Stenosis in Europe: 2000–2017

Hartley

Hammond‐Haley

Marshall

et al. 2021

Front. Cardiovasc. Med.

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Background: Trends in mortality from aortic stenosis across European countries are not well-understood, especially given the significant growth in transcatheter aortic valve implantation (TAVI) in the last 10 years.Methods: Age-standardised death rates were extracted from the World Health Organisation Mortality Database, using the International Classification of Diseases 10th edition code for non-rheumatic aortic stenosis for those aged > 45 years between 2000 and 2017. The UK and countries from the European Union with at least 1,000,000 inhabitants and at least 50% available datapoints over the study period were included: a total of 23 countries. Trends were described using Joinpoint regression analysis.Results: No reductions in mortality were demonstrated across all countries 2000–2017. Large increases in mortality were found for Croatia, Poland and Slovakia for both sexes (>300% change). Mortality plateaued in Germany from 2008 in females and 2012 in males, whilst mortality in the Netherlands declined for both sexes from 2007. Mortality differences between the sexes were observed, with greater mortality for males than females across most countries.Conclusions: Mortality from aortic stenosis has increased across Europe from 2000 to 2017. There are, however, sizable differences in mortality trends between Eastern and Western European countries. The need for health resource planning strategies to specifically target AS, particularly given the expected increase with ageing populations, is highlighted.

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Section: Discussionmentioning

confidence: 99%

Trends in Mortality From Aortic Stenosis in Europe: 2000–2017

Hartley

Hammond‐Haley

Marshall

et al. 2021

Front. Cardiovasc. Med.

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show abstract

“…Yapılan bilgisayarlı tomografi çalışmalarında erkeklerde aort kapak kalsifikasyonu ile stenozun ciddiyeti arasında bir oran varken kadınlarda bu saptanmamıştı,. Aort stenoz derecesinde erkeklerde kapak kalsifıkasyonu daha yüksektir 8 , kadın hastaların aort kapak anuler seviyedeki kalsifikasyonun erkeklere kıyasla daha az olduğu bunun kapağa bağlı gelişebilecek komplikasyonları daha az olmasına katkı sağlayabileceği gösterilmiştir 9 . Kapak kalsifikasyonunun patofizyolojisi, sol ventrikülün basınç artışına yanıtı cinsiyetler arası farklılık göstermektedir, AD'ında basınç yüklenmesine miyokart cevabı kadın hastalarda konsantrik remodelling iken erkek hastalarda ventrikülde genişleme ile sonuçlanan maladaptif remodelling cevabı olur 10 .…”

Section: Discussionunclassified

“…TAVI işlemi sonrasında paravalvüler kaçağın uzun dönemde kötü sonlanımla ilişkisi bilinmektedir. Bu durum kadınların uzun dönemde daha iyi sağkalıma sahip olmalarına katkı sağlıyor olabilir 9 .…”

Section: Discussionunclassified

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Transkateter Aortik Kapak Replasmanında Kısa Süreli Takipte Cinsiyet Farkı

Urgun¹,

Traş²,

Kurt³

et al. 2020

City Med J

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Introduction: The prognostic value sex difference demonstrated in cardiovascular diseases. In present study, we evaluated the prognostic value of sex difference in patients who underwent transcatheter aortic valve replacement (TAVI). Material and Methods: Totally, 130 patients who underwent TAVI between January 2016 and December 2018 included retrospectively. Median follow-up time was 324 (IQR 226) days. Demographic characteristic of patients recorded from hospital record system and patients’ fields. Primary outcome was all cause mortality during follow-up. Results: Mean age of study population was 77.1 ± 7.8 years and female gender was significantly older than male gender. There was no significant difference between groups in term of demographic and laboratory parameters except smoker rate and mean haemoglobin level. During follow-up totally 34 (%26.2) patients were died (male 34.5%, female 20.0%; p= 0.062) and there was no significant difference between groups. Conclusion: In our single-center retrospective study, we showed that there was no significant difference in gender difference in all-cause mortality during short-term follow-up after TAVI.

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“…To allow for a straightforward and simple assessment of patient skin dose during the procedure or at the end of the intervention, multiple studies focused on the correlation of peak skin dose (PSD) with online dose indicators such as fluoroscopy time, air kerma area product (P K,A ), and air kerma at interventional reference point ( K a,r ) (8,16–20). Nonetheless, such simple regression models often show weak correlations due to the exclusion of other clinical and technical confounding parameters, which can affect patient exposure (21,22). Furthermore, several software solutions have been developed to assess PSD during or after these procedures (13).…”

Section: Introductionmentioning

confidence: 99%

Establishing a priori and a posteriori predictive models to assess patients’ peak skin dose in interventional cardiology. Part 2: results of the VERIDIC project

et al. 2021

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Background Optimizing patient exposure in interventional cardiology is key to avoid skin injuries. Purpose To establish predictive models of peak skin dose (PSD) during percutaneous coronary intervention (PCI), chronic total occlusion percutaneous coronary intervention (CTO), and transcatheter aortic valve implantation (TAVI) procedures. Material and Methods A total of 534 PCI, 219 CTO, and 209 TAVI were collected from 12 hospitals in eight European countries. Independent associations between PSD and clinical and technical dose determinants were examined for those procedures using multivariate statistical analysis. A priori and a posteriori predictive models were built using stepwise multiple linear regressions. A fourfold cross-validation was performed, and models’ performance was evaluated using the root mean square error (RMSE), mean absolute percentage error (MAPE), coefficient of determination (R²), and linear correlation coefficient (r). Results Multivariate analysis proved technical parameters to overweight clinical complexity indices with PSD mainly affected by fluoroscopy time, tube voltage, tube current, distance to detector, and tube angulation for PCI. For CTO, these were body mass index, tube voltage, and fluoroscopy contribution. For TAVI, these parameters were sex, fluoroscopy time, tube voltage, and cine acquisitions. When benchmarking the predictive models, the correlation coefficients were r = 0.45 for the a priori model and r = 0.89 for the a posteriori model for PCI. These were 0.44 and 0.67, respectively, for the CTO a priori and a posteriori models, and 0.58 and 0.74, respectively, for the TAVI a priori and a posteriori models. Conclusion A priori predictive models can help operators estimate the PSD before performing the intervention while a posteriori models are more accurate estimates and can be useful in the absence of skin dose mapping solutions

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Sex and Transcatheter Aortic Valve Implantation: Impact of Female Sex on Clinical Outcomes

Cited by 9 publications

References 48 publications

Trends in Mortality From Aortic Stenosis in Europe: 2000–2017

Trends in Mortality From Aortic Stenosis in Europe: 2000–2017

Transkateter Aortik Kapak Replasmanında Kısa Süreli Takipte Cinsiyet Farkı

Establishing a priori and a posteriori predictive models to assess patients’ peak skin dose in interventional cardiology. Part 2: results of the VERIDIC project

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