title: Comparison of variables in men versus women undergoing transcatheter aortic valve implantation for severe aortic stenosis (from Italian Multicenter CoreValve registry).
abstract: Although transcatheter aortic valve implantation (TAVI) for severe aortic stenosis is becoming an established technique, the effect of gender-related differences is poorly described. We performed a gender-based comparison of high-risk patients undergoing TAVI with the self-expandable CoreValve Revalving System for severe aortic stenosis to evaluate early and mid-term clinical outcomes. From the Italian prospective CoreValve registry, 659 consecutive patients (55.8% women) who underwent TAVI were included in the present study. We analyzed the gender-based differences in terms of clinical, angiographic, and procedural features and the differences in the rate of early and mid-term major adverse cardiac and cerebrovascular events. The men were younger, presented more often with severe left ventricular dysfunction, and had a greater rate of previous myocardial infarction, coronary revascularization, peripheral artery disease, renal failure, and heart conduction disorders than the women. The logistic European System for Cardiac Operative Risk Evaluation score did not differ between the 2 groups. The overall unadjusted and adjusted analyses failed to show significant differences between genders in terms of major adverse cardiac and cerebrovascular events at a median follow-up of 13 months (range 8 to 18). At late follow-up (landmark analysis >12 months), a survival benefit was observed in women (hazard ratio 0.27, 95% confidence interval 0.09 to 0.84, p = 0.02). In conclusion, in this multicenter registry, the gender-based comparison of TAVI patients showed that men, despite the younger age, had more extensive atherosclerotic burden compared to women. Overall, the early and mid-term outcomes were similar between genders, although women might have a survival benefit with longer follow-up.
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Buja
authors.forename: Massimo
authors.initials: M
authors.lastname: Napodano
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
authors.forename: Anna Sonia
authors.initials: AS
authors.lastname: Petronio
authors.forename: Federica
authors.initials: F
authors.lastname: Ettori
authors.forename: Gennaro
authors.initials: G
authors.lastname: Santoro
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Ussia
authors.forename: Silvio
authors.initials: S
authors.lastname: Klugmann
authors.forename: Francesco
authors.initials: F
authors.lastname: Bedogni
authors.forename: Angelo
authors.initials: A
authors.lastname: Ramondo
authors.forename: Francesco
authors.initials: F
authors.lastname: Maisano
authors.forename: Antonio
authors.initials: A
authors.lastname: Marzocchi
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Poli
authors.forename: Valeria
authors.initials: V
authors.lastname: Gasparetto
authors.forename: David
authors.initials: D
authors.lastname: Antoniucci
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tarantini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D006328:Cardiac Catheterization; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D012720:Severity of Illness Index; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends