Four-year mortality in women and men after transfemoral transcatheter aortic valve implantation using the SAPIEN 3
Language English Country United States Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
Grant support
Edwards Lifesciences
PubMed
32886851
DOI
10.1002/ccd.29257
Knihovny.cz E-resources
- Keywords
- gender, mortality rate, predictors of mortality, sex differences, transcatheter aortic valve implantation,
- MeSH
- Aortic Valve diagnostic imaging surgery MeSH
- Aortic Valve Stenosis * diagnostic imaging surgery MeSH
- Humans MeSH
- Registries MeSH
- Risk Factors MeSH
- Heart Valve Prosthesis * MeSH
- Transcatheter Aortic Valve Replacement * adverse effects MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
OBJECTIVES: To investigate 4-year, post-transcatheter aortic valve implantation (TAVI) survival and predictors of survival by sex, in a real-world cohort that underwent transfemoral TAVI with SAPIEN 3 transcatheter heart valve. BACKGROUND: Previous TAVI investigations of first-generation devices demonstrated an early- to mid-term survival advantage in women compared with men. METHODS: SOURCE 3 (SAPIEN 3 Aortic Bioprosthesis European Outcome) is a post-approval, multicentre, observational registry. Patients (N = 1,694, 49.2% women, age 81.7 ± 6.7 years) with severe aortic stenosis and high surgical risk (logistic EuroSCORE 17.8%) underwent TAVI between 2014 and 2015. Kaplan-Meier event estimates were used to determine mortality by sex. Predictors of overall mortality were identified using a cox multivariate proportional hazard model. RESULTS: At 4 years, women had lower all-cause mortality than men (36.0 vs 39.7%; p = .0911; HR: 0.87 [95% CI: 0.75-1.02]). No difference was observed for cardiac mortality between women 24.2% and men 24.7% (p = .76; HR: 0.97 [95% CI: 0.79-1.19]). When adjusted for baseline characteristics (age, height, weight, NYHA functional class, renal insufficiency, EuroScore, and tricuspid regurgitation), sex had no impact on mortality. CONCLUSIONS: In this large, real-world cohort, all-cause mortality trended lower in women than men at 4 years post TAVI; however, several baseline factors, but not sex, were predictors of mortality. No difference between sexes was observed for cardiovascular mortality.
Department of Cardiac Thoracic and Vascular Science University of Padova Padova Italy
Department of Cardiology 3 University Hospital Münster Münster Germany
Department of Cardiology Klinik für Innere Medizin St Johannes Hospital Dortmund Germany
Department of Cardiothoracic Surgery King's College Hospital London UK
Statistics Department Edwards Lifesciences Prague Czech Republic
University Hospital Basel University of Basel Basel Switzerland
University Hospital Schleswig Holstein Kiel Germany and DZHK Kiel Germany
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