Comparison in Men Versus Women of Co-morbidities, Complications, and Outcomes After Transcatheter Aortic Valve Implantation for Severe Aortic Stenosis.

MedStar author(s):
Citation: American Journal of Cardiology. 118(11):1692-1697, 2016 Dec 01PMID: 27666174Institution: MedStar Health Research InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Aortic Valve Stenosis/su [Surgery] | *Coronary Artery Disease/ep [Epidemiology] | *Postoperative Complications/ep [Epidemiology] | *Risk Assessment | *Transcatheter Aortic Valve Replacement/ae [Adverse Effects] | Aged, 80 and over | Aortic Valve Stenosis/di [Diagnosis] | Aortic Valve Stenosis/ep [Epidemiology] | Cause of Death/td [Trends] | Comorbidity | District of Columbia/ep [Epidemiology] | Female | Follow-Up Studies | Humans | Male | Retrospective Studies | Risk Factors | Severity of Illness Index | Sex Distribution | Survival Rate/td [Trends] | Time FactorsYear: 2016Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0002-9149
Name of journal: The American journal of cardiologyAbstract: Copyright 2016 Elsevier Inc. All rights reserved.Transcatheter aortic valve implantation (TAVI) decreases mortality in high-risk patients with severe aortic stenosis, but it remains unclear if female gender is associated with more favorable outcomes after TAVI. All patients who underwent TAVI at a single institution were retrospectively analyzed and stratified by gender. Procedural, in-hospital, 30-day, and 1-year outcomes were defined according to the second Valve Academic Research Consortium. The primary end point was all-cause mortality at 1 year. Kaplan-Meier survival analysis and multivariable Cox proportional hazards regression were conducted. Overall, 755 patients underwent TAVI and were included in the study; 50.7% were women. Average age was 83.0 +/- 7.7 years, with a mean Society of Thoracic Surgeons score of 8.9 +/- 4.6. Women were older than men and more likely to be black. Most co-morbidities were less common among women, and they were more likely than men to suffer both in-hospital (8.4% vs 4.3%, p = 0.021) and 30-day (9.4% vs 5.4%, p = 0.035) all-cause mortality. Life-threatening bleeding, transfusion, and iliofemoral dissection or perforation were more common among women. There was no difference in mortality between women and men at 1 year (20.6% vs 21.5%, log-rank p = 0.87). After multivariable adjustment, however, female gender was independently associated with lower mortality at 1 year after TAVI. In conclusion, despite higher rates of major bleeding, vascular complications, and 30-day mortality, female gender was independently associated with improved survival at 1 year after TAVI.All authors: Ben-Dor I, Bernardo NL, Gaglia MA Jr, Gai J, Lipinski MJ, Pichard AD, Satler LF, Torguson R, Waksman RFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-04-11
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 27666174 Available 27666174

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

Copyright 2016 Elsevier Inc. All rights reserved.

Transcatheter aortic valve implantation (TAVI) decreases mortality in high-risk patients with severe aortic stenosis, but it remains unclear if female gender is associated with more favorable outcomes after TAVI. All patients who underwent TAVI at a single institution were retrospectively analyzed and stratified by gender. Procedural, in-hospital, 30-day, and 1-year outcomes were defined according to the second Valve Academic Research Consortium. The primary end point was all-cause mortality at 1 year. Kaplan-Meier survival analysis and multivariable Cox proportional hazards regression were conducted. Overall, 755 patients underwent TAVI and were included in the study; 50.7% were women. Average age was 83.0 +/- 7.7 years, with a mean Society of Thoracic Surgeons score of 8.9 +/- 4.6. Women were older than men and more likely to be black. Most co-morbidities were less common among women, and they were more likely than men to suffer both in-hospital (8.4% vs 4.3%, p = 0.021) and 30-day (9.4% vs 5.4%, p = 0.035) all-cause mortality. Life-threatening bleeding, transfusion, and iliofemoral dissection or perforation were more common among women. There was no difference in mortality between women and men at 1 year (20.6% vs 21.5%, log-rank p = 0.87). After multivariable adjustment, however, female gender was independently associated with lower mortality at 1 year after TAVI. In conclusion, despite higher rates of major bleeding, vascular complications, and 30-day mortality, female gender was independently associated with improved survival at 1 year after TAVI.

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