This article is more than 5 years old. Information may no longer be current.
Similar outcomes in men, women after TAVR despite disparities
Clinical outcomes did not significantly differ in men and women who underwent transcatheter aortic valve replacement, even in the presence of gender disparities in procedural management and clinical presentation, according to a study published in The American Journal of Cardiology.
Ting-Yu Wang, BS, of the division of cardiovascular medicine at State University of New York at Stony Brook, and colleagues analyzed data from 298 patients with severe symptomatic aortic stenosis and/or failure with a bioprosthetic valve. Men (n = 154; mean age, 79 years) and women (n = 144; mean age, 81 years) underwent TAVR with a newer transcatheter heart valve (Sapien 3, Edwards Lifesciences; CoreValve Evolut R or Evolut Pro, Medtronic) between December 2015 and June 2018.
Baseline demographic and medical history data that were assessed include factors such as sex, age, previous CABG, BMI, previous aortic valve replacement, previous MI and atrial fibrillation. Clinical data were also extracted and included CTA, echocardiographic data, discharge data and procedural information.
Women were more often older, had lower rates of previous CABG, lower serum creatinine, lower rate of AF and lower rate of previous MI compared with men. Women also had smaller perimeter and aortic annual area on CTA vs. men. Implantation of smaller transcatheter heart valves were performed more often in women compared with men.
P2Y12 inhibitors, mainly clopidogrel, were prescribed more often at discharge to women vs. men. In addition, women were less frequently prescribed an oral anticoagulant at discharge, primarily warfarin.
Men and women had similar rates of in-hospital outcomes. There were also no differences in the median length of stay in men and women from admission to discharge (3 days for both; P = .336).
“Our study had a number of limitations,” Wang and colleagues wrote. “First, our findings are based on observational data, which was internally validated, but not centrally adjudicated. Second, the majority of the devices implanted during the study period were balloon-expandable in nature and nearly all cases were transfemoral approach. Third, we did not examine for differences in outcomes according to TAVI time period. Finally, our study was limited to in-hospital outcomes.” – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.