Abstract 13919: Comparison of Clinical Outcomes After Trans-catheter Aortic Valve Implantation in Men and Women for Severe Aortic Stenosis
Comparison of Clinical Outcomes after Trans-catheter Aortic Valve Implantation in Men and Women for Severe Aortic Stenosis
Objectives: To evaluate sex related differences in clinical outcomes after transcatheter aortic valve implantation (TAVI) for aortic stenosis by means of a meta-analysis.
Background: Sex-related disparities in clinical outcomes after TAVI have been reported in a limited number of patients. We conducted a meta-analysis of all available literature to assess pooled outcomes in men and women after TAVI.
Methods: A comprehensive literature search from 01/01/2000 till 05/21/2013 identified 7 studies comparing men and women who underwent TAVI for severe aortic stenosis. All-cause mortality was evaluated at 30-days,12 & 24 months follow-up. Odds ratio(OR) and 95% confidence interval(CI) were calculated using random effects model.
Results: A total of 3555 patients[55% women] were included. Women were more likely to be older & had higher prevalence of HTN, porcelain aorta, pulmonary hypertension, CHF and NYHA class III-IV. Men had higher prevalence of prior CAD, MI, PAD and tobacco use. Echocardiographic and hemodynamic studies revealed smaller aortic valve area & aortic annulus diameter with higher peak(85.8±8.8mmHg vs. 76.4±3.2mmHg) and mean(47.6±6.0mmHg vs. 43.7±3.1mmHg) gradient across LVOT in women.At 30-day follow-up, women experienced lower all-cause mortality compared to men(4.6% vs. 8.0%;OR 0.59 95% CI 0.39-0.91). All-cause mortality remained lower in women at 12 & 24 month follow-up(Table). Women suffered from higher rates of major vascular and major bleeding complications. The two groups had comparable rates of MI, stroke & pacemaker implantation.
Conclusion: In this meta-analysis of all available data comprising 3,555 patients, women exhibited lower all-cause mortality up to 24-months post-TAVI despite higher rates of major vascular and bleeding complications.
Meta-Analysis Showing Clinical Outcomes and Complications
- © 2013 by American Heart Association, Inc.