Comparison in Men Versus Women of Co-morbidities, Complications, and Outcomes After Transcatheter Aortic Valve Implantation for Severe Aortic Stenosis
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- 作者：Michael A. Gaglia Jr. ; MD ; MSc ; michael.a.gaglia@medstar.net" class="auth_mail" title="E-mail the corresponding author ; Michael J. Lipinski ; MD ; PhD ; Rebecca Torguson ; MPH ; Jiaxiang Gai ; PhD ; Itsik Ben-Dor ; MD ; Nelson L. Bernardo ; MD ; Lowell F. Satler ; MD ; Augusto D. Pichard ; MD ; Ron Waksman ; MD
- 刊名：The American Journal of Cardiology
- 出版年：2016
- 出版时间：1 December 2016
- 年：2016
- 卷：118
- 期：11
- 页码：1692-1697
- 全文大小：647 K
文摘
Transcatheter aortic valve implantation (TAVI) decreases mortality in high-risk patients with severe aortic stenosis, but it remains unclear if female gender is associated with more favorable outcomes after TAVI. All patients who underwent TAVI at a single institution were retrospectively analyzed and stratified by gender. Procedural, in-hospital, 30-day, and 1-year outcomes were defined according to the second Valve Academic Research Consortium. The primary end point was all-cause mortality at 1 year. Kaplan–Meier survival analysis and multivariable Cox proportional hazards regression were conducted. Overall, 755 patients underwent TAVI and were included in the study; 50.7% were women. Average age was 83.0 ± 7.7 years, with a mean Society of Thoracic Surgeons score of 8.9 ± 4.6. Women were older than men and more likely to be black. Most co-morbidities were less common among women, and they were more likely than men to suffer both in-hospital (8.4% vs 4.3%, p = 0.021) and 30-day (9.4% vs 5.4%, p = 0.035) all-cause mortality. Life-threatening bleeding, transfusion, and iliofemoral dissection or perforation were more common among women. There was no difference in mortality between women and men at 1 year (20.6% vs 21.5%, log-rank p = 0.87). After multivariable adjustment, however, female gender was independently associated with lower mortality at 1 year after TAVI. In conclusion, despite higher rates of major bleeding, vascular complications, and 30-day mortality, female gender was independently associated with improved survival at 1 year after TAVI.