Women Do Better After TAVI, Hints Small Study

January 30, 2012

January 30, 2012 (Massy, France) — Women fare better than men following transcatheter aortic-valve implantation (TAVI) for severe aortic stenosis, according to an initial look at this subject [1].

This is the "first precise description of sex-related differences in patients with severe aortic stenosis undergoing TAVI using both the Edwards valve and the CoreValve," say Dr Kentaro Hayashida (Institut Cardiovasculaire Paris Sud, Massy, France) and colleagues in the February 7, 2012 issue of the Journal of the American College of Cardiology.

Hayashida et al reviewed data from 260 subjects who underwent TAVI to determine whether there were differences between the genders in presentation or outcomes.

Women had fewer comorbidities--less coronary and peripheral disease, less previous cardiac surgery, and higher ejection fractions--and a lower EuroSCORE. But they had a smaller body size, as well as smaller femoral, aorta, and aortic annulus sizes. Nevertheless, similar device success was achieved in women and men alike with an adequate reduction in the transprosthetic pressure gradient, the authors say. Women had more iliac complications, however (9.0% vs 2.5% in men; p=0.030).

No significant relationship of gender with 30-day mortality was seen, but women had better one-year survival (76% vs 65% for men), and male sex was identified as a predictor of midterm mortality (hazard ratio 1.62).

The researchers point out that this is a single-center study, and multivariate analysis was not performed because of the low end-point count. "Further studies of larger patient populations are required to confirm our results," they conclude.

Hayashida reports no conflicts of interest; disclosures for the coauthors are listed in the paper.


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