Sex-Specific Outcomes of Transcatheter Aortic Valve Replacement With the SAPIEN 3 Valve

Szerlip, Molly; Gualano, Sarah K.; Holper, Elizabeth M.; Squiers, John J.; White, Jonathon; Doshi, Darshan; Williams, Mathew; Hahn, Rebecca T.; Webb, John G.; Svensson, Lars G.; Kirtane, Ajay J.; Cohen, David J.; Douglas, Pamela S.; Alu, Maria; Crowley, Aaron; Tuzcu, E. Murat; Makkar, Raj; Herrmann, Howard C.; Babaliaros, Vasilis; Thourani, Vinod H.; Leon, Martin B.; Kodali, Susheel; Mack, Michael J.

doi:10.1016/j.jcin.2017.09.035

Cited by 61 publications

(48 citation statements)

References 20 publications

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“…However, data on sex‐related mortality with third generation THVs are limited to a sub‐analysis of the PARTNER‐II S3 High‐Risk and Intermediate‐Risk Cohorts ( n = 1,661, 40% women). In this analysis, women demonstrated higher 30‐day mortality than men (2.0 vs. 1.2%), though not reaching statistical significance ( p = .20) 17 . Our analysis of 44,280 patients who underwent TAVR between January 2018 and March 2020 showed significantly higher in‐hospital TAVR mortality in women which persisted after risk‐adjustment and PSM.…”

Section: Discussioncontrasting

confidence: 49%

Sex‐specific in‐hospital outcomes of transcatheter aortic valve replacement with third generation transcatheter heart valves

Simard

Alqahtani

Hibbert

et al. 2021

Cathet Cardio Intervent

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Background Sex‐based differences in transcatheter aortic valve replacement (TAVR) outcomes have been previously documented. However, whether these differences persist with contemporary third generation transcatheter heart valves (THVs) is unknown. Methods We utilized Vizient's clinical database/resource manager (CDB/RM™) to identify patients who underwent TAVR between January 1, 2018 and March 31, 2020 to compare in‐hospital outcomes between males and females. The primary endpoint was in‐hospital mortality. Secondary endpoints included key in‐hospital complications, length of stay, discharge disposition, and cost. Unadjusted, propensity‐score matched and risk‐adjusted analyses of outcomes were performed. Results During the study period, 44,280 patients (24,842 males, 19,438 females) underwent TAVR. The primary endpoint of in‐hospital mortality was higher in females than in males (1.6 vs. 1.1% p < .001) in unadjusted analysis and persisted following propensity matching (1.6 vs. 0.9%, p < .001) and multivariable logistic regression with various risk‐adjustment models. In the most comprehensive model adjusting for age, race, and clinical comorbidities, female sex was associated with 34% greater odds of in‐hospital death (95% CI 20–50%, p < .001). Unadjusted and risk‐adjusted rates of post‐TAVR stroke, vascular complication, and blood transfusion were higher in females. Moreover, females demonstrated longer hospitalizations, higher costs and reduced rates of independent discharge home. Conclusion Sex‐based differences in TAVR in‐hospital outcomes persist in contemporary practice with third generation transcatheter heart valves. Further research is needed to assess the reasons for these observed disparities and to identify effective mitigation strategies.

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Section: Discussioncontrasting

confidence: 49%

Sex‐specific in‐hospital outcomes of transcatheter aortic valve replacement with third generation transcatheter heart valves

Simard

Alqahtani

Hibbert

et al. 2021

Cathet Cardio Intervent

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“…A previous study indicated better survival in women, 23 whereas other studies have indicated no differences between men and women after short-and mid-term follow-up. 24, 25 The lower incidence of cardiovascular death among women may be related to the low proportion of patients with cardiovascular disease risk at baseline, as shown in this study. According to the latest World Health Organization data, Japanese people, particularly women, have had the world's longest average life expectancy since 1985.…”

Section: Sex-related Differences In Mortality After Tavimentioning

confidence: 59%

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

Shishido

Yamanaka

Ochiai

et al. 2021

Circ J

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“…(20). Indeed, in TAVI procedure major vascular complications are experienced more frequent in women, probably related to low body surface area and smaller peripheral vessels (21). In WIN TAVI (Women's International Transcatheter Aortic Valve Implantation), an international, multicenter, prospective observational registry of 1019 female patients undergoing TAVI, the Valve Academic Research Consortium 2 (VARC-2) early safety end point (composite of mortality, stroke, major vascular complications, life-threatening bleeding, stage 2 or 3 acute kidney injury, coronary artery obstruction, or repeat procedure for valve-related dysfunction) is reported in 14% and it is manly driven by vascular complications (7.7%) (22) (Fig.…”

Section: Aortic Valve Diseasementioning

confidence: 99%

Heart valve disease gender difference in the era of transcatether treatment

Aurigemma¹,

Burzotta²,

Trani³

2023

HVT

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Available data have demonstrated important sex-related differences in patients with valvular heart disease, regarding clinical presentation, treatment, and outcomes. Although the calcific aortic stenosis (AS) is more frequent in men compared to women, the majority of AS patients over 80 years old are women, in whom fibrotic remodeling of aortic valve is typically found. Mitral valve disease is more common in women. However females are under-referred or delayed referrals to treatment, probably due to the absence of sex-based LV dimension values guiding surgical timing. The development of transcatheter devices have revolutionized the treatment of valvular heart disease and increased the interest in this topic. In this context, the consideration of gender differences in presentation, diagnosis, treatment success, and prognosis is of great importance.

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Sex-Specific Outcomes of Transcatheter Aortic Valve Replacement With the SAPIEN 3 Valve

Abstract: The study found no apparent sex-specific differences in survival or stroke in this trial of TAVR. This may reflect the changing demographic of patients enrolled, use of newer-generation valves with more sizes available, and more accurate valve sizing techniques.

Cited by 61 publications

References 20 publications

Sex‐specific in‐hospital outcomes of transcatheter aortic valve replacement with third generation transcatheter heart valves

Sex‐specific in‐hospital outcomes of transcatheter aortic valve replacement with third generation transcatheter heart valves

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

Heart valve disease gender difference in the era of transcatether treatment

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