title: Gender-related differences on short- and long-term outcomes of patients undergoing transcatheter aortic valve implantation.
abstract: OBJECTIVE
  This study aimed to compare gender-related differences in outcomes of patients undergoing TAVI over a long-term follow-up period.
  
  
  BACKGROUND
  Transcatheter aortic valve implantation (TAVI) has been considered the standard therapy for patients with inoperable or high-risk symptomatic aortic stenosis. The influence of gender-related differences in outcomes of patients undergoing TAVI is currently on debate.
  
  
  METHODS
  From January 2008 to January 2015, 819 patients (49% men) underwent TAVI and were included in a multicenter Brazilian registry. Patients were followed-up and clinical outcomes were evaluated according to the updated Valve Academic Research Consortium-2 criteria.
  
  
  RESULTS
  Mean follow-up was 497 ± 478 days. Compared with women, men had a lower rate of major or life-threatening bleeding (12.0% vs. 20.6%; HR = 0.57 [95CI% 0.40-0.81]; P = 0.001), and major vascular complications (6% vs. 11.7%; HR = 0.50 [95CI% 0.31-0.82]; P = 0.004). At 30 days, all-cause mortality was lower in men than in women (6.5% vs. 11.5%; P = 0.013), however, cumulative all-cause mortality was similar between groups (25.9% vs. 29.7%, men and women, respectively, HR = 0.92 [95CI% 0.71-1.19]; P = 0.52) over the entire follow-up period. By adjusted Cox regression model, renal function, diabetes, peripheral artery disease, and chronic obstructive pulmonary disease (COPD) remained independently predictors of all-cause mortality.
  
  
  CONCLUSIONS
  In this large-scale study evaluating patients undergoing TAVI, 30-day mortality was higher among women than men driven by significant higher rates of major or life-threatening bleeding and major vascular complications. However, all-cause mortality on long-term follow-up was similar between groups. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Katz
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Antonio
authors.initials: A
authors.lastname: Carlos Bacelar Nunes Filho
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Adriano
authors.initials: A
authors.lastname: Caixeta
authors.affiliation: Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brazil.
authors.forename: Luiz
authors.initials: L
authors.lastname: Antonio Carvalho
authors.affiliation: Instituto de Cardiologia do Rio Grande do Sul/Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
authors.forename: Rogério
authors.initials: R
authors.lastname: Sarmento-Leite
authors.affiliation: Heart Institute (InCor), University of Sao Paulo Medical School, São Paulo, SP, Brazil.
authors.forename: Pedro
authors.initials: P
authors.lastname: Alves Lemos Neto
authors.affiliation: Hospital S.O.S Cardio, Florianópolis, SC, Brazil.|Instituto de Cardiologia de Santa Catarina, São José, SC, Brazil.
authors.forename: Luiz
authors.initials: L
authors.lastname: Eduardo Koenig São Thiago
authors.affiliation: Hospital Santa Izabel da Santa Casa de Misericórdia da Bahia, Salvador, BA, Brazil.
authors.forename: Adriano
authors.initials: A
authors.lastname: Dias Dourado Oliveira
authors.affiliation: Hospital Madre Teresa, Belo Horizonte, MG, Brazil.
authors.forename: Marcos
authors.initials: M
authors.lastname: Antonio Marino
authors.affiliation: Associação Hospitalar Beneficente São Vicente de Paulo, Passo Fundo, RS, Brazil.
authors.forename: Rogerio
authors.initials: R
authors.lastname: Tadeu Tumelero
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Marco
authors.initials: M
authors.lastname: Antonio Perin
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.|Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Abizaid
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.|Heart Institute (InCor), University of Sao Paulo Medical School, São Paulo, SP, Brazil.
authors.forename: Flavio
authors.initials: F
authors.lastname: Tarasoutchi
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Fábio
authors.initials: F
authors.lastname: Sândoli de Brito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D001938:Brazil; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000401:mortality; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D054624:Health Status Disparities; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000401:mortality; D006439:Hemodynamics; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000209:etiology
keywords: TAVI; TAVR; aortic valve stenosis; gender; outcomes