Mamoru Toyofuku1, Tomohiko Taniguchi2, Takeshi Morimoto3, Kyohei Yamaji4, Yutaka Furukawa5, Kosuke Takahashi1, Takashi Tamura1, Hiroki Shiomi2, Kenji Ando4, Norio Kanamori6, Koichiro Murata7, Takeshi Kitai5, Yuichi Kawase8, Chisato Izumi9, Makoto Miyake9, Hirokazu Mitsuoka10, Masashi Kato11, Yutaka Hirano12, Shintaro Matsuda2, Tsukasa Inada13, Tomoyuki Murakami14, Yasuyo Takeuchi15, Keiichiro Yamane16, Mitsuru Ishii17, Eri Minamino-Muta2, Takao Kato2, Moriaki Inoko18, Tomoyuki Ikeda19, Akihiro Komasa20, Katsuhisa Ishii20, Kozo Hotta21, Nobuya Higashitani22, Yoshihiro Kato23, Yasutaka Inuzuka24, Chiyo Maeda25, Toshikazu Jinnai22, Yuko Morikami26, Naritatsu Saito2, Kenji Minatoya27, Takeshi Kimura2. 1. Department of Cardiology, Japanese Red Cross Wakayama Medical Center. 2. Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine. 3. Department of Clinical Epidemiology, Hyogo College of Medicine. 4. Department of Cardiology, Kokura Memorial Hospital. 5. Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital. 6. Division of Cardiology, Shimada Municipal Hospital. 7. Department of Cardiology, Shizuoka City Shizuoka Hospital. 8. Department of Cardiovascular Medicine, Kurashiki Central Hospital. 9. Department of Cardiology, Tenri Hospital. 10. Division of Cardiology, Nara Hospital, Kinki University Faculty of Medicine. 11. Department of Cardiology, Mitsubishi Kyoto Hospital. 12. Department of Cardiology, Kindai University Hospital. 13. Department of Cardiovascular Center, Osaka Red Cross Hospital. 14. Department of Cardiology, Koto Memorial Hospital. 15. Department of Cardiology, Shizuoka General Hospital. 16. Department of Cardiology, Nishikobe Medical Center. 17. Department of Cardiology, National Hospital Organization Kyoto Medical Center. 18. Cardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital. 19. Department of Cardiology, Hikone Municipal Hospital. 20. Department of Cardiology, Kansai Electric Power Hospital. 21. Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center. 22. Department of Cardiology, Japanese Red Cross Otsu Hospital. 23. Department of Cardiology, Saiseikai Noe Hospital. 24. Department of Cardiology, Shiga Medical Center for Adults. 25. Department of Cardiology, Hamamatsu Rosai Hospital. 26. Department of Cardiology, Hirakata Kohsai Hospital. 27. Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine.
Abstract
BACKGROUND: There is a paucity of data on the sex differences in the prevalence, clinical presentation, and prognosis of aortic stenosis (AS).Methods and Results: A total of 3,815 consecutive patients with severe AS were enrolled in the multicenter CURRENT AS registry between January 2003 and December 2011. The registry included 1,443 men (38%) and 2,372 women (62%). Women were much older than men (79±10 vs. 75±10 years, P<0.0001), and the ratio of women to men increased with age. The cumulative 5-year incidence of all-cause death was significantly higher in men than in women (47% vs. 41%, P=0.003), although women were more symptomatic and much older. The 5-year mortality was similar between men and women at age <65 years (16% vs. 15%, P=0.99), whereas it was significantly higher in men than in women at age ≥65 years (65-74 years, 38% vs. 19%, P<0.0001; 75-84 years, 55% vs. 34%, P<0.0001; ≥85 years: 82% vs. 72%, P=0.03). CONCLUSIONS: A large Japanese multicenter registry of consecutive patients with severe AS included a much higher proportion of women than men, with the female:male sex ratio increasing with age. The 5-year mortality rate of women was lower than that of men. Lower 5-year mortality rates in women were consistently seen across all age groups >65 years.
BACKGROUND: There is a paucity of data on the sex differences in the prevalence, clinical presentation, and prognosis of aortic stenosis (AS).Methods and Results: A total of 3,815 consecutive patients with severe AS were enrolled in the multicenter CURRENT AS registry between January 2003 and December 2011. The registry included 1,443 men (38%) and 2,372 women (62%). Women were much older than men (79±10 vs. 75±10 years, P<0.0001), and the ratio of women to men increased with age. The cumulative 5-year incidence of all-cause death was significantly higher in men than in women (47% vs. 41%, P=0.003), although women were more symptomatic and much older. The 5-year mortality was similar between men and women at age <65 years (16% vs. 15%, P=0.99), whereas it was significantly higher in men than in women at age ≥65 years (65-74 years, 38% vs. 19%, P<0.0001; 75-84 years, 55% vs. 34%, P<0.0001; ≥85 years: 82% vs. 72%, P=0.03). CONCLUSIONS: A large Japanese multicenter registry of consecutive patients with severe AS included a much higher proportion of women than men, with the female:male sex ratio increasing with age. The 5-year mortality rate of women was lower than that of men. Lower 5-year mortality rates in women were consistently seen across all age groups >65 years.
Entities:
Keywords:
Aortic stenosis; Aortic valve replacement; Mortality; Sex difference
Authors: Jacqueline T DesJardin; Joanna Chikwe; Rebecca T Hahn; Judy W Hung; Francesca N Delling Journal: Circ Res Date: 2022-02-17 Impact factor: 17.367