Clinical impact of sex differences and procedural setting in transcatheter aortic valve implantation.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Ravani Lis Victória, Ribeiro Henrique Barbosa, Calomeni Pedro, de Brito Fábio Sandoli, Bernardi Fernando, Lemos Pedro, Feres Fausto, Siqueira Dimytri Alexandre, Costa Ricardo, Sarmento-Leite Rogério, Mangione Fernanda, Mangione José Armando, Thiago Luiz Eduardo Koenig São, de Lima Valter Correia, Oliveira Adriano Dias Dourado, Marino Marcos Antônio, Cardoso Carlos José Francisco, Caramori Paulo Ricardo Avancini, Tumelero Rogério Tadeu, Portela Antenor Lages Fortes, Prudente Maurício Lopes, Henriques Leônidas Alvarenga, de Freitas Souza Fabio Solano, Bezerra Cristiano Guedes, de Almeida Prado Junior Guy Fernandes, de Freitas Leandro Zacarias Figueiredo, Nogueira Ederlon Ferreira, Meirelle George César Ximenes, Pope Renato Bastos, Guérios Ênio Eduardo, de Andrade Pedro Beraldo, de Moura Santos Luciano, de Sá Marchi Mauricio Felippi, Esteves Vinicius Borges Cardozo, Abizaid Alexandre
Аннотация
METHODS: The RIBAC-NT (Brazilian Registry for Evaluation of Transcatheter Aortic Valve Replacement Outcomes) dataset included 3194 TAVI patients from 2009 to 2021. This retrospective analysis explored disparities in baseline characteristics, procedural and in-hospital outcomes stratifying patients by sex and procedural setting. Temporal trends were also investigated.
RESULTS: We included 1551 (49 %) female and 1643 (51 %) male patients. Women were older (83 [78-87] vs. 81 [75-85] years; p < 0.01) but had a lower prevalence of diabetes mellitus (30.2 % vs. 36.3 %, p < 0.01) and coronary artery disease (39.0 % vs. 52.2 %, p < 0.01). However, women had a 3-fold higher higher risk of life-threatening bleeding (6.1 % vs. 2.4 %, p < 0.01). Women presented higher procedural and in-hospital mortality rates (4.4 % vs. 2.5 % and 7.7 % vs. 4.5 %, all p < 0.01, respectively). Although public hospitals presented ~2-fold higher procedural mortality rate compared with private settings (5.0 % vs. 2.7 %, p < 0.01), after multivariable analysis procedural setting was not independently associated with in-hospital mortality.
CONCLUSIONS: Women had higher procedural and in-hospital mortality rates after TAVI as compared with men, while facing higher life-threatening bleeding and adverse events rates. Although public hospitals exhibited higher mortality rates than private centers, procedural setting was not independently associated with in-hospital mortality.