Rami Gabani, Salvatore Brugaletta, Kamil Bujak, María José Pèrez-Vizcayno, Pilar Jimenez-Quevedo, Victor Arévalos, Erika Muñoz-García, Ramiro Trillo-Nouche, Raquel Del Valle, Jose M de la Torre Hernandez, Luisa Salido, Enrique Gutierrez, Manuel Pan, Joaquin Sanchez-Gila, Bruno Garcia Del Blanco, Raul Moreno, Roberto Blanco Mata, Juan Francisco Oteo, Ignacio Amat-Santos, Ander Regueiro, Francisco Ten, Juan Manuel Nogales, Eduard Fernandez-Nofrerias, Leire Andraka, Maria Cruz Ferrer, Eduardo Pinar, Rafael Romaguera, Carlos Cuellas Ramon, Fernando Alfonso, Sergio Garcia-Blas, Antonio Pinero, Julia Ignasi, Rocio Diaz Mendez, Pascual Bordes, Juan Meseguer, Luis Nombela-Franco, Manel Sabaté
{"title":"Impact of gender on in-hospital and long-term outcomes after transcatheter aortic valve implantation: an analysis of the Spanish TAVI registry.","authors":"Rami Gabani, Salvatore Brugaletta, Kamil Bujak, María José Pèrez-Vizcayno, Pilar Jimenez-Quevedo, Victor Arévalos, Erika Muñoz-García, Ramiro Trillo-Nouche, Raquel Del Valle, Jose M de la Torre Hernandez, Luisa Salido, Enrique Gutierrez, Manuel Pan, Joaquin Sanchez-Gila, Bruno Garcia Del Blanco, Raul Moreno, Roberto Blanco Mata, Juan Francisco Oteo, Ignacio Amat-Santos, Ander Regueiro, Francisco Ten, Juan Manuel Nogales, Eduard Fernandez-Nofrerias, Leire Andraka, Maria Cruz Ferrer, Eduardo Pinar, Rafael Romaguera, Carlos Cuellas Ramon, Fernando Alfonso, Sergio Garcia-Blas, Antonio Pinero, Julia Ignasi, Rocio Diaz Mendez, Pascual Bordes, Juan Meseguer, Luis Nombela-Franco, Manel Sabaté","doi":"10.1016/j.rec.2024.08.002","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction and objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>The study included 12 253 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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":null,"pages":null},"PeriodicalIF":7.2000,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista española de cardiología (English ed.)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.rec.2024.08.002","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
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 12 253 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.