Wieneke Vlastra1, Jaya Chandrasekhar2, Bruno García Del Blanco3, Didier Tchétché4, Fabio S de Brito5, Marco Barbanti6, Ran Kornowski7, Azeem Latib8, Augusto D'Onofrio9, Flavio Ribichini10, Jan Baan1, Jan G P Tijssen1, Raul Moreno11, Nicolas Dumonteil4, Flavio Tarasoutchi5, Samantha Sartori12, Paola D'Errigo13, Giuseppe Tarantini9, Mattia Lunardi10, Katia Orvin7, Matteo Pagnesi8, Alberto Berenguer14, Thomas Modine15, George Dangas12, Roxana Mehran12, Jan J Piek1, Ronak Delewi16. 1. Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, the Netherlands. 2. Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, the Netherlands; Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. 3. Department of Cardiology, Vall d'Hebron University Hospital, Barcelona, Spain. 4. Clinique Pasteur, Toulouse, France. 5. Heart Institute, University of São Paulo Medical School, São Paulo, Brazil. 6. Division of Cardiology, Policlinico-Vittorio Emanuele Hospital, University of Catania, Catania, Italy. 7. Cardiology Department, Rabin Medical Center, Petah Tikva, Israel. 8. Division of Cardiology, Montefiore Medical Center, New York, New York. 9. Division of Cardiac Surgery, University of Padova, Padua, Italy. 10. Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy. 11. University Hospital La Paz, Madrid, Spain; Instituto de Investigación Hospital La Paz (IDIPAZ), Madrid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. 12. Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. 13. National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy. 14. Cardiology Department, Hospital General de Valencia, Valencia, Spain. 15. Centre Hospitalier Universitaire, Lille, France. 16. Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, the Netherlands. Electronic address: r.delewi@amsterdamumc.nl.
Abstract
BACKGROUND:Transfemoral aortic valve replacement (TAVR) is a guideline-recommended treatment option for patients with severe aortic valve stenosis. Women and men present with different baseline characteristics, which may influence procedural outcomes. OBJECTIVES: This study sought to evaluate differences between women and men undergoing transfemoral TAVR across the globe during the last decade. METHODS: The CENTER (Cerebrovascular EveNts in patients undergoingTranscathetER aortic valve implantation with balloon-expandable valves versus self-expandable valves)-collaboration was a global patient level dataset of patients undergoingtransfemoral TAVR (N = 12,381) from 2007 to 2018. In this retrospective analysis, the study examined differences in baseline patient characteristics, 30-day stroke and mortality, and in-hospital outcomes between female and male patients. The study also assessed for temporal changes in outcomes and predictors for mortality per sex. RESULTS: We included 58% (n = 7,120) female and 42% (n = 5,261) male patients. Women had higher prevalence of hypertension and glomerular filtration rate <30 ml/min/1.73 m2 but lower prevalence of all other traditional cardiovascular comorbidities. Both sexes had similar rates of 30-day stroke (2.3% vs. 2.5%; p = 0.53) and mortality (5.9% vs. 5.5%; p = 0.17). In contrast, women had a 50% higher risk of life-threatening or major bleeding (6.7% vs. 4.4%; p < 0.01). Over the study period, mortality rates decreased to a greater extent in men than in women (60% vs. 50% reduction; both p < 0.001), with no reductions in stroke rates over time. CONCLUSIONS: In this global collaboration, women and men had similar rates of 30-day mortality and stroke. However, women had higher rates of procedural life-threatening or major bleeding after TAVR. Between 2007 and 2018, mortality rates decreased to a greater extent in men than in women.
RCT Entities:
BACKGROUND: Transfemoral aortic valve replacement (TAVR) is a guideline-recommended treatment option for patients with severe aortic valve stenosis. Women and men present with different baseline characteristics, which may influence procedural outcomes. OBJECTIVES: This study sought to evaluate differences between women and men undergoing transfemoral TAVR across the globe during the last decade. METHODS: The CENTER (Cerebrovascular EveNts in patients undergoing TranscathetER aortic valve implantation with balloon-expandable valves versus self-expandable valves)-collaboration was a global patient level dataset of patients undergoing transfemoral TAVR (N = 12,381) from 2007 to 2018. In this retrospective analysis, the study examined differences in baseline patient characteristics, 30-day stroke and mortality, and in-hospital outcomes between female and male patients. The study also assessed for temporal changes in outcomes and predictors for mortality per sex. RESULTS: We included 58% (n = 7,120) female and 42% (n = 5,261) male patients. Women had higher prevalence of hypertension and glomerular filtration rate <30 ml/min/1.73 m2 but lower prevalence of all other traditional cardiovascular comorbidities. Both sexes had similar rates of 30-day stroke (2.3% vs. 2.5%; p = 0.53) and mortality (5.9% vs. 5.5%; p = 0.17). In contrast, women had a 50% higher risk of life-threatening or major bleeding (6.7% vs. 4.4%; p < 0.01). Over the study period, mortality rates decreased to a greater extent in men than in women (60% vs. 50% reduction; both p < 0.001), with no reductions in stroke rates over time. CONCLUSIONS: In this global collaboration, women and men had similar rates of 30-day mortality and stroke. However, women had higher rates of procedural life-threatening or major bleeding after TAVR. Between 2007 and 2018, mortality rates decreased to a greater extent in men than in women.
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
Authors: Paul T L Chiam; Kentaro Hayashida; Yusuke Watanabe; Wei-Hsian Yin; Hsien-Li Kao; Michael K Y Lee; Fabio Enrique Posas; Mann Chandavimol; Wacin Buddhari; Timothy C Dy; Ngoc Quang Nguyen; Won Jang Kim; Kiyuk Chang; Mao-Shin Lin; Yat-Yin Lam; Hung Manh Pham; Shaiful Azmi Yahaya; Kay Woon Ho; Wenzhi Pan; Xian-Bao Liu; Jian'an Wang; Hyo Soo Kim; Mao Chen Journal: Open Heart Date: 2021-01