Impact of gender on in-hospital and long-term outcomes after transcatheter aortic valve implantation: an analysis of the Spanish TAVI registry.

Autores de IIS La Fe

• Francisco Ten Morro

  Autor

Participantes ajenos a IIS La Fe

• Gabani, Rami
• Brugaletta, Salvatore
• Bujak, Kamil
• Perez-Vizcayno, Maria Jose
• Jimenez-Quevedo, Pilar
• Arevalos, Victor
• Munoz-Garcia, Erika
• Trillo-Nouche, Ramiro
• Valle, Raquel Del
• de la Torre Hernandez, Jose M
• Salido, Luisa
• Gutierrez, Enrique
• Pan, Manuel
• Sanchez-Gila, Joaquin
• Del Blanco, Bruno Garcia
• Moreno, Raul
• Mata, Roberto Blanco
• Oteo, Juan Francisco
• Amat-Santos, Ignacio
• Regueiro, Ander
• Nogales, Juan Manuel
• Fernandez-Nofrerias, Eduard
• Andraka, Leire
• Cruz Ferrer, Maria
• Pinar, Eduardo
• Romaguera, Rafael
• Ramon, Carlos Cuellas
• Alfonso, Fernando
• Garcia-Blas, Sergio
• Pinero, Antonio
• Ignasi, Julia
• Diaz Mendez, Rocio
• Bordes, Pascual
• Meseguer, Juan
• Nombela-Franco, Luis
• Sabate, Manel

Grupos

• Regeneración y Trasplante Cardíaco

Abstract

INTRODUCTION AND OBJECTIVES: Impact of gender on long-term outcomes after transcatheter aortic valve implantation (TAVI) remains uncertain. We aimed to investigate gender-specific differences in TAVI and its impact on outcomes. METHODS: This analysis used data from the prospective Spanish TAVI registry, which included consecutive TAVI patients treated in 46 Spanish centers from 2009 to 2021. The primary endpoint was all-cause mortality at 12 months. Secondary endpoints included in-hospital and 30-day mortality and TAVI-related complications. Adjusted logistic and Cox regression analyses were performed. RESULTS: The study included 12253 consecutive TAVI patients with a mean age of 81.2 ± 6.4 years. Women (53.9%) were older, and had a higher STS-PROM score (7.0 ± 7.0 vs 6.2 ± 6.7; P < .001) than men. Overall, the TAVI-related complication rate was similar between women and men, with specific gender-related complications. While women more frequently developed in-hospital vascular complications (13.6% vs 9.8%; P<.001) and cardiac tamponade (1.5% vs 0.6%; P=.009), men showed a higher incidence of permanent pacemaker implantation (14.5% vs 17.4%; P=.009). There was no difference in all-cause mortality either in hospital (3.6% vs 3.6%, adjusted odds ratio [OR], 1.01; 95% confidence interval [95%CI], 0.83-1.23; P=.902), at 30 days (4.2% vs 4.2%, adjusted OR, 0.90; 95%CI, 0.65-1.25; P=.564) or at 1 year (11% vs 13%, adjusted HR, 0.94; [0.80-1.11]; P=.60). CONCLUSIONS: women treated with TAVI are older and have more comorbidities than men, leading to distinct complications between genders. Nevertheless, all-cause mortality in the short-term and at 1-year was similar between men and women.

Copyright © 2024 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Keywords

• Gender; Implante de marcapasos permanente; Implante percutáneo de válvula aórtica; Permanent pacemaker implantation; Reemplazo quirúrgico de válvula aórtica; Sexo; Surgical aortic valve replacement; Transcatheter aortic valve implantation