Abstract 19652: Gender Disparities Among Patients Undergoing Transcatheter Aortic Valve Replacement
Background: Previous studies have suggested higher rates of mortality among female patients undergoing surgical aortic valve replacement, but gender disparities in transcatheter aortic valve replacement (TAVR) patients are not well-studied.
Objectives: We sought to compare 30-day and 1-year outcomes in female vs. male patients undergoing TAVR for severe, symptomatic AS.
Methods: Consecutive patients undergoing TAVR at a single center were stratified according to gender. We compared female v. male patients in regards to the incidence of comorbidities, in addition to 30-day and 1-year outcomes according to the Valve Academic Research Consortium (VARC) criteria. A Cox proportional hazards regression was performed to assess for an independent association of female gender and mortality at 1 year.
Results: The study population included 362 female and 354 male patients. Females were less likely to suffer from a number of comorbidities than males, including a coronary artery disease (63.8% v. 84.3%, p<0.001), peripheral vascular disease (26.3% v. 41.8%, p<0.001), and chronic renal insufficiency (41.7% v. 53.6%, p=0.002). Despite this, females had a higher average STS score (9.9 v. 8.2; p<0.001). Females were more likely to have a life-threatening bleed (9.9% vs. 5.4%, p=0.03), although there was only a trend for more major vascular complications (11.8% vs. 8.2%, p=0.11). Females also had higher rates of in-hospital (7.8% vs. 3.7%, p=0.02) and 30-day mortality (9.7% vs. 5.6%, p=0.04), although there was no difference at 1 year (21.0% vs. 21.5%, p=0.88). Following multivariable adjustment, there was no independent association of gender and mortality at 1 year.
Conclusions: Females undergoing TAVR suffer higher rates of short-term mortality, but outcomes at 1 year are similar to males. This suggests that there may be a hazard to female gender periprocedurally, but long term this difference is abolished because of a lesser burden of comorbidities.
Author Disclosures: M.A. Gaglia: Speakers Bureau; Modest; AstraZeneca. R.M. Torguson: None. M.J. Lipinski: None. I. Ben-Dor: None. L. Satler: None. A. Pichard: None. R. Waksman: None.
- © 2015 by American Heart Association, Inc.