Impact of gender on in-hospital and long-term outcomes after transcatheter aortic valve implantation: an analysis of the Spanish TAVI registry.
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Gabani Rami, Brugaletta Salvatore, Bujak Kamil, Pèrez-Vizcayno María José, Jiménez-Quevedo Pilar, Arévalos Víctor, Muñoz-García Erika, Trillo-Nouche Ramiro, Del Valle Raquel, de la Torre Hernández José M, Salido Luisa, Gutiérrez Enrique, Pan Manuel, Sánchez-Gila Joaquín, García Del Blanco Bruno, Moreno Raúl, Blanco Mata Roberto, Oteo Juan Francisco, Amat-Santos Ignacio, Regueiro Ander, Ten Francisco, Nogales Juan Manuel, Fernández-Nofrerías Eduard, Andraka Leire, Ferrer María Cruz, Pinar Eduardo, Romaguera Rafael, Cuellas Ramón Carlos, Alfonso Fernando, García-Blas Sergio, Piñero Antonio, Ignasi Julia, Díaz Mèndez Rocío, Bordes Pascual, Meseguer Juan, Nombela-Franco Luis, Sabaté Manel
Аннотация
METHODS: This analysis used data from the prospective Spanish TAVI registry, which included consecutive TAVI patients treated in 46 Spanish centers from 2009 to 2021. The primary endpoint was all-cause mortality at 12 months. Secondary endpoints included in-hospital and 30-day mortality and TAVI-related complications. Adjusted logistic and Cox regression analyses were performed.
RESULTS: The study included 12 253 consecutive TAVI patients with a mean age of 81.2±6.4 years. Women (53.9%) were older, and had a higher STS-PROM score (7.0±7.0 vs 6.2±6.7; P < .001) than men. Overall, the TAVI-related complication rate was similar between women and men, with specific gender-related complications. While women more frequently developed in-hospital vascular complications (13.6% vs 9.8%; P <.001) and cardiac tamponade (1.5% vs 0.6%; P=.009), men showed a higher incidence of permanent pacemaker implantation (14.5% vs 17.4%; P=.009). There was no difference in all-cause mortality either in hospital (3.6% vs 3.6%, adjusted OR, 1.01; 95%CI, 0.83-1.23; P=.902), at 30 days (4.2% vs 4.2%, adjusted OR, 0.90; 95%CI, 0.65-1.25; P=.564) or at 1 year (11% vs 13%, adjusted HR, 0.94; 95%CI, 0.80-1.11; P=.60).
CONCLUSIONS: Women treated with TAVI are older and have more comorbidities than men, leading to distinct complications between genders. Nevertheless, all-cause mortality in the short-term and at 1-year was similar between men and women.