Journal of cardiovascular electrophysiology · 2025
Sex Differences in Periprocedural Safety Outcomes and Mortality Following Cardiac Implantable Electronic Device Transvenous Lead Extraction.
СтатьяНаблюдательное исследованиеСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Borkowski Pawel, Schiavone Marco, Zou Fengwei Jasper, Nazarenko Natalia, Alhuarrat Majd Al Deen, Maliha Maisha, Apple Sam, Rahgozar Kusha, Fazia Vincenzo Mirco La, Zhang Xiaodong, Pugliese Daniel, Guttenplan Nils, Mohanty Sanghamitra, Natale Andrea, Lin Aung, Lakkireddy Dhanunjaya, Marazzato Jacaopo, Ammirati Giuseppe, Di Biase Luigi
Аннотация
BACKGROUND: Cardiac implantable electronic devices (CIEDs) play a vital role in modern electrophysiology but are prone to complications, necessitating transvenous lead extraction (TLE) in certain cases. Recent studies suggest sex-based disparities in cardiovascular outcomes, yet little is known about sex differences in TLE complications.
OBJECTIVE: This study aimed to evaluate sex-related differences in peri-procedural outcomes following TLE.
METHODS: We conducted a retrospective, observational cohort study using the National Inpatient Sample (NIS) from 2016 to 2019. Patients undergoing TLE due to CIED-related issues were identified using ICD-10 codes. Exclusions included patients with concurrent cardiac surgeries or incomplete outcome data. Propensity score matching (1:1) was used to balance demographic and clinical variables between sexes. Multivariate and univariate logistic regression analyses were performed to assess outcomes, with statistical significance set at p < 0.05.
RESULTS: The final matched cohort included 20 970 admissions (10 480 men; 10 490 women). No significant sex-based difference in in-hospital mortality was observed (OR: 1.12, p = 0.184). However, women exhibited increased risks for cardiac complications (OR: 1.24) and pulmonary complications (OR: 1.21), including higher rates of pericardial effusion, tamponade, pneumothorax, and hemothorax. Men showed a higher incidence of vascular complications (OR: 0.76).
CONCLUSIONS: Despite similar in-hospital mortality, women patients undergoing TLE experienced significantly higher rates of cardiac and pulmonary complications compared to men. These findings highlight the need for sex-specific risk assessment and procedural planning to improve safety and outcomes in TLE.
OBJECTIVE: This study aimed to evaluate sex-related differences in peri-procedural outcomes following TLE.
METHODS: We conducted a retrospective, observational cohort study using the National Inpatient Sample (NIS) from 2016 to 2019. Patients undergoing TLE due to CIED-related issues were identified using ICD-10 codes. Exclusions included patients with concurrent cardiac surgeries or incomplete outcome data. Propensity score matching (1:1) was used to balance demographic and clinical variables between sexes. Multivariate and univariate logistic regression analyses were performed to assess outcomes, with statistical significance set at p < 0.05.
RESULTS: The final matched cohort included 20 970 admissions (10 480 men; 10 490 women). No significant sex-based difference in in-hospital mortality was observed (OR: 1.12, p = 0.184). However, women exhibited increased risks for cardiac complications (OR: 1.24) and pulmonary complications (OR: 1.21), including higher rates of pericardial effusion, tamponade, pneumothorax, and hemothorax. Men showed a higher incidence of vascular complications (OR: 0.76).
CONCLUSIONS: Despite similar in-hospital mortality, women patients undergoing TLE experienced significantly higher rates of cardiac and pulmonary complications compared to men. These findings highlight the need for sex-specific risk assessment and procedural planning to improve safety and outcomes in TLE.