title: Effect of gender after transcatheter aortic valve implantation: a meta-analysis.
abstract: BACKGROUND
  The effect of gender on patients with aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) remains to be defined.
  
  
  METHODS
  MEDLINE, Cochrane Library, and Scopus databases were searched for articles describing sex differences in baseline characteristics, procedures, and outcomes. All-cause death at follow-up of at least 1 year was the primary end point, and the independent effect of female gender was evaluated with pooled analysis using a random-effect model and with meta-regression.
  
  
  RESULTS
  Six studies with 6,645 patients were included, half of them being women presenting with lower European System for Cardiac Operative Risk Evaluation (EuroSCORE) compared with men. At 30 days, more frequent major vascular complications and major and life-threatening bleeding occurred in women, with lower rates of moderate to severe aortic regurgitation, whereas 30-day mortality was similar. After a median follow-up of 365 days (range, 365 to 730 days) all-cause mortality was 24.0% in women and 34.0% in men. A pooled analysis of the multivariable approach found female gender was significantly related to a lower risk of death (odds ratio, 0.82; 95% CI, confidence interval, 0.73 to 0.93; I(2) = 0%). A meta-regression analysis showed age, ejection fraction, previous cardiovascular accident, renal insufficiency, and access site did not influence these data.
  
  
  CONCLUSIONS
  Female patients undergoing TAVI present with a lower burden of comorbidities. The counterbalance between higher rates of vascular complications but lower of valve regurgitation may explain the reduced risk for women after TAVI, independently from baseline features and access site.
authors: Division of Cardiology, Città Della Salute e della Scienza Hospital, Turin, Italy. Electronic address: federico.conrotto@gmail.com.
authors: Federico
authors: F
authors: Conrotto
authors: Division of Cardiology, Città Della Salute e della Scienza Hospital, Turin, Italy.
authors: Fabrizio
authors: F
authors: D'Ascenzo
authors: Division of Cardiology, Istituto Clinico Humanitas, Milan, Italy.
authors: Patrizia
authors: P
authors: Presbitero
authors: Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
authors: Karin H
authors: KH
authors: Humphries
authors: Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
authors: John G
authors: JG
authors: Webb
authors: Institut Cardiovasculaire Paris Sud, Massy, France.
authors: Stephen A
authors: SA
authors: O'Connor
authors: Institut Cardiovasculaire Paris Sud, Massy, France.
authors: Marie-Claude
authors: MC
authors: Morice
authors: Institut Cardiovasculaire Paris Sud, Massy, France.
authors: Thierry
authors: T
authors: Lefèvre
authors: Division of Cardiology, Città Della Salute e della Scienza Hospital, Turin, Italy.
authors: Costanza
authors: C
authors: Grasso
authors: Division of Cardiology, Città Della Salute e della Scienza Hospital, Turin, Italy.
authors: Pierluigi
authors: P
authors: Sbarra
authors: Division of Cardiology, Città Della Salute e della Scienza Hospital, Turin, Italy; Division of Cardiology, Assuit University Hospital, Assuit, Egypt.
authors: Salma
authors: S
authors: Taha
authors: Division of Cardiology, Città Della Salute e della Scienza Hospital, Turin, Italy.
authors: Pierluigi
authors: P
authors: Omedè
authors: Division of Cardiology, Città Della Salute e della Scienza Hospital, Turin, Italy.
authors: Walter
authors: W
authors: Grosso Marra
authors: Department of Surgical Sciences, University of Torino, Turin, Italy.
authors: Stefano
authors: S
authors: Salizzoni
authors: Division of Cardiology, Città Della Salute e della Scienza Hospital, Turin, Italy.
authors: Claudio
authors: C
authors: Moretti
authors: Division of Cardiology, Città Della Salute e della Scienza Hospital, Turin, Italy.
authors: Maurizio
authors: M
authors: D'Amico
authors: Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.
authors: Giuseppe
authors: G
authors: Biondi-Zoccai
authors: Division of Cardiology, Città Della Salute e della Scienza Hospital, Turin, Italy.
authors: Fiorenzo
authors: F
authors: Gaita
authors: Division of Cardiology, Città Della Salute e della Scienza Hospital, Turin, Italy.
authors: Sebastiano
authors: S
authors: Marra
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D017678:Sex Distribution; D012737:Sex Factors; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*