BACKGROUND: The effect of gender on patients with aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) remains to be defined. METHODS: MEDLINE, Cochrane Library, and Scopus databases were searched for articles describing sex differences in baseline characteristics, procedures, and outcomes. All-cause death at follow-up of at least 1 year was the primary end point, and the independent effect of female gender was evaluated with pooled analysis using a random-effect model and with meta-regression. RESULTS: Six studies with 6,645 patients were included, half of them being women presenting with lower European System for Cardiac Operative Risk Evaluation (EuroSCORE) compared with men. At 30 days, more frequent major vascular complications and major and life-threatening bleeding occurred in women, with lower rates of moderate to severe aortic regurgitation, whereas 30-day mortality was similar. After a median follow-up of 365 days (range, 365 to 730 days) all-cause mortality was 24.0% in women and 34.0% in men. A pooled analysis of the multivariable approach found female gender was significantly related to a lower risk of death (odds ratio, 0.82; 95% CI, confidence interval, 0.73 to 0.93; I(2) = 0%). A meta-regression analysis showed age, ejection fraction, previous cardiovascular accident, renal insufficiency, and access site did not influence these data. CONCLUSIONS: Female patients undergoing TAVI present with a lower burden of comorbidities. The counterbalance between higher rates of vascular complications but lower of valve regurgitation may explain the reduced risk for women after TAVI, independently from baseline features and access site.
BACKGROUND: The effect of gender on patients with aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) remains to be defined. METHODS: MEDLINE, Cochrane Library, and Scopus databases were searched for articles describing sex differences in baseline characteristics, procedures, and outcomes. All-cause death at follow-up of at least 1 year was the primary end point, and the independent effect of female gender was evaluated with pooled analysis using a random-effect model and with meta-regression. RESULTS: Six studies with 6,645 patients were included, half of them being women presenting with lower European System for Cardiac Operative Risk Evaluation (EuroSCORE) compared with men. At 30 days, more frequent major vascular complications and major and life-threatening bleeding occurred in women, with lower rates of moderate to severe aortic regurgitation, whereas 30-day mortality was similar. After a median follow-up of 365 days (range, 365 to 730 days) all-cause mortality was 24.0% in women and 34.0% in men. A pooled analysis of the multivariable approach found female gender was significantly related to a lower risk of death (odds ratio, 0.82; 95% CI, confidence interval, 0.73 to 0.93; I(2) = 0%). A meta-regression analysis showed age, ejection fraction, previous cardiovascular accident, renal insufficiency, and access site did not influence these data. CONCLUSIONS: Female patients undergoing TAVI present with a lower burden of comorbidities. The counterbalance between higher rates of vascular complications but lower of valve regurgitation may explain the reduced risk for women after TAVI, independently from baseline features and access site.
Authors: Norman Mangner; Georg Stachel; Felix Woitek; Stephan Haussig; Florian Schlotter; Robert Höllriegel; Jennifer Adam; Anna Lindner; Friedrich W Mohr; Gerhard Schuler; Philipp Kiefer; Sergey Leontyev; Michael A Borger; Holger Thiele; David Holzhey; Axel Linke Journal: J Am Heart Assoc Date: 2018-04-13 Impact factor: 5.501
Authors: Richard Paul Steeds; David Messika-Zeitoun; Jeetendra Thambyrajah; Antonio Serra; Eberhard Schulz; Jiri Maly; Marco Aiello; Tanja K Rudolph; Guy Lloyd; Alessandro Santo Bortone; Alberto Clerici; Georg Delle-Karth; Johannes Rieber; Ciro Indolfi; Massimo Mancone; Loic Belle; Alexander Lauten; Martin Arnold; Berto J Bouma; Matthias Lutz; Cornelia Deutsch; Jana Kurucova; Martin Thoenes; Peter Bramlage; Norbert Frey Journal: Open Heart Date: 2021-01
Authors: Nooraldaem Yousif; Slayman Obeid; Ronald Binder; Andrea Denegri; Mohammady Shahin; Christian Templin; Thomas F Lüscher Journal: J Geriatr Cardiol Date: 2018-06 Impact factor: 3.327
Authors: Hatim Seoudy; Moritz Lambers; Vincent Winkler; Linnea Dudlik; Sandra Freitag-Wolf; Johanne Frank; Christian Kuhn; Ashraf Yusuf Rangrez; Thomas Puehler; Georg Lutter; Peter Bramlage; Norbert Frey; Derk Frank Journal: Clin Res Cardiol Date: 2020-10-24 Impact factor: 5.460