Sex Differences in Transfemoral Transcatheter Aortic Valve Replacement.

Aged Aged, 80 and over Aortic Valve / surgery Aortic Valve Stenosis / surgery Catheterization, Peripheral / methods Europe / epidemiology Female Femoral Artery Humans Male Postoperative Complications Prognosis Prospective Studies Risk Assessment / methods Risk Factors Sex Distribution Sex Factors Survival Rate / trends Transcatheter Aortic Valve Replacement / methods

outcome differences over time predictors of 30-day mortality sex differences transfemoral aortic valve implantation

Journal

Journal of the American College of Cardiology

ISSN: 1558-3597

Titre abrégé: J Am Coll Cardiol

Pays: United States

ID NLM: 8301365

Informations de publication

Date de publication:
03 12 2019

Historique:

received: 26 08 2019

revised: 12 09 2019

accepted: 13 09 2019

pubmed: 29 9 2019

medline: 27 5 2020

entrez: 29 9 2019

Statut: ppublish

Résumé

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. This study sought to evaluate differences between women and men undergoing transfemoral TAVR across the globe during the last decade. 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. 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 m 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.

Sections du résumé

BACKGROUND

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 m

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.

Identifiants

DOI: 10.1016/j.jacc.2019.09.015 PMID: 31562908

pubmed: 31562908

pii: S0735-1097(19)37669-7

doi: 10.1016/j.jacc.2019.09.015

pii:

doi:

Types de publication

Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

Pagination

2758-2767

Commentaires et corrections

Type : CommentIn