新一代经导管心脏瓣膜置换术后的性别差异:系统回顾和荟萃分析。

Q1 Medicine
Angkawipa Trongtorsak, Sittinun Thangjui, Pabitra Adhikari, Biraj Shrestha, Jakrin Kewcharoen, Leenhapong Navaravong, Somsupha Kanjanauthai, Steve Attanasio, Hammad A Saudye
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引用次数: 1

摘要

先前的研究表明,经导管主动脉瓣置换术(TAVR)和早期经导管心脏瓣膜(thv)术后的死亡率和血管并发症存在性别差异。然而,目前尚不清楚,与性别相关的差异是否在新一代的thv中持续存在。我们的目的是评估新一代thv在TAVR后的性别差异。MEDLINE和Embase数据库从建立到2023年4月进行了全面检索,以确定报告使用新一代thv (Sapien 3、Corevalve Evolut R和Evolut Pro)进行TAVR后性别特异性结果的研究。研究结果包括30天死亡率、1年死亡率和血管并发症。共纳入5项研究(4个数据库),47,933例患者(女性21073例,男性26,860例)。96%的患者通过经股入路接受TAVR。女性患者的30天死亡率(优势比(OR) = 1.53, 95%可信区间(CI) 1.31-1.79, p值(p) < 0.001)和血管并发症(OR = 1.43, 95% CI 1.23-1.65, p < 0.001)较高。然而,两组一年死亡率相似(OR = 0.78, 95% CI 0.61-1.00, p = 0.28)。女性仍然与新一代经导管心脏瓣膜TAVR术后30天死亡率和血管并发症相关,而1年死亡率在性别之间没有差异。需要更多的数据来探索原因以及我们是否可以改善女性TAVR的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis.

Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis.

Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis.

Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis.

Previous studies have demonstrated gender disparities in mortality and vascular complications after transcatheter aortic valve replacement (TAVR) with early generation transcatheter heart valves (THVs). It is unclear, however, whether gender-related differences persist with the newer generation THVs. We aim to assess gender disparities after TAVR with newer generation THVs. The MEDLINE and Embase databases were thoroughly searched from inception to April 2023 to identify studies that reported gender-specific outcomes after TAVR with newer generation THVs (Sapien 3, Corevalve Evolut R, and Evolut Pro). The outcomes of interest included 30-day mortality, 1-year mortality, and vascular complications. In total, 5 studies (4 databases) with a total of 47,933 patients (21,073 females and 26,860 males) were included. Ninety-six percent received TAVR via the transfemoral approach. The females had higher 30-day mortality rates (odds ratio (OR) = 1.53, 95% confidence interval (CI) 1.31-1.79, p-value (p) < 0.001) and vascular complications (OR = 1.43, 95% CI 1.23-1.65, p < 0.001). However, one-year mortality was similar between the two groups (OR = 0.78, 95% CI 0.61-1.00, p = 0.28). The female gender continues to be associated with higher 30-day mortality rates and vascular complications after TAVR with newer generation transcatheter heart valves, while there was no difference in 1-year mortality between the genders. More data is needed to explore the causes and whether we can improve TAVR outcomes in females.

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