title: Influence of gender on clinical outcomes following transcatheter aortic valve implantation from the UK transcatheter aortic valve implantation registry and the National Institute for Cardiovascular Outcomes Research.
abstract: Gender differences exist in outcomes after percutaneous coronary intervention and coronary artery bypass graft surgery but have yet to be fully explored after transcatheter aortic valve implantation. We aimed to investigate gender differences after transcatheter aortic valve implantation in the UK National Institute for Cardiovascular Outcomes Research registry. A retrospective analysis was performed of Medtronic CoreValve and Edwards SAPIEN implantation in 1,627 patients (756 women) from January 2007 to December 2010. Men had more risk factors: poor left ventricular systolic function (11.9% vs 5.5%, p <0.001), 3-vessel disease (19.4% vs 9.2%, p <0.001), previous myocardial infarction (29.5% vs 13.0%, p <0.001), peripheral vascular disease (32.4% vs 23.3%, p <0.001), and higher logistic EuroSCORE (21.8 ± 14.2% vs 21.0 ± 13.4%, p = 0.046). Thirty-day mortality was 6.3% (confidence interval 4.3% to 7.9%) in women and 7.4% (5.6% to 9.2%) in men and at 1 year, 21.9% (18.7% to 25.1%) and 22.4% (19.4% to 25.4%), respectively. There was no mortality difference: p = 0.331 by log-rank test; hazard ratio for women 0.91 (0.75 to 1.10). Procedural success (96.6% in women vs 96.4% in men, p = 0.889) and 30-day cerebrovascular event rates (3.8% vs 3.7%, p = 0.962) did not differ. Women had more major vascular complications (7.5% vs 4.2%, p = 0.004) and less moderate or severe postprocedural aortic regurgitation (7.5% vs 12.5%, p = 0.001). In conclusion, despite a higher risk profile in men, there was no gender-related mortality difference; however, women had more major vascular complications and less postprocedural moderate or severe aortic regurgitation.
authors: Imperial College Healthcare NHS Trust, London, United Kingdom. Electronic address: rallamee@gmail.com.
authors: Rasha
authors: R
authors: Al-Lamee
authors: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors: Christopher
authors: C
authors: Broyd
authors: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors: Jessica
authors: J
authors: Parker
authors: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors: Justin E
authors: JE
authors: Davies
authors: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors: Jamil
authors: J
authors: Mayet
authors: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors: Nilesh
authors: N
authors: Sutaria
authors: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors: Ben
authors: B
authors: Ariff
authors: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors: Beth
authors: B
authors: Unsworth
authors: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors: Jonathan
authors: J
authors: Cousins
authors: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors: Colin
authors: C
authors: Bicknell
authors: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors: Jonathan
authors: J
authors: Anderson
authors: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors: Iqbal S
authors: IS
authors: Malik
authors: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors: Andrew
authors: A
authors: Chukwuemeka
authors: Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
authors: Daniel J
authors: DJ
authors: Blackman
authors: Royal Brompton and Harefield NHS Trust, London, United Kingdom.
authors: Neil
authors: N
authors: Moat
authors: Queen Elizabeth Hospital, University of Birmingham, Birmingham, United Kingdom.
authors: Peter F
authors: PF
authors: Ludman
authors: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors: Darrel P
authors: DP
authors: Francis
authors: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors: Ghada W
authors: GW
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mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006328:Cardiac Catheterization; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012042:Registries; D012189:Retrospective Studies; D017678:Sex Distribution; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology