AUTHOR=Lodo Vittoria , Italiano Enrico G. , Weltert Luca , Zingarelli Edoardo , Perrucci Chiara , Pietropaolo Claudio , Buono Gabriella , Centofanti Paolo 

TITLE=The influence of gender on outcomes following transcatheter aortic valve implantation

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1417430

DOI=10.3389/fcvm.2024.1417430

ISSN=2297-055X

ABSTRACT=<sec><title>Objectives</title><p>This study aimed to compare gender-related differences in short- and long-term outcomes after transcatheter aortic valve implantation.</p></sec><sec><title>Methods</title><p>Patients who underwent transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) from September 2017 to December 2022 were enrolled. The primary endpoint was 5-year all-cause mortality. The secondary endpoints were 30-day mortality and the incidence of post-procedural complication. Patients were separated according to gender before statistical analysis. To compare patients with similar baseline characteristics, we performed a propensity matching.</p></sec><sec><title>Results</title><p>A total of 704 patients [females, 361 (51.3%); males, 343 (48.7%)] were enrolled. Compared to women, men had a higher incidence of smoking (40.5% vs. 14.7%, <italic>p</italic> &lt; 0.001), diabetes (32.9% vs. 25.1%, <italic>p</italic> &lt; 0.025), peripheral artery disease (35.8% vs. 18.3%, <italic>p</italic> &lt; 0.001), and previous cardiac surgery (13.7% vs. 7.2%, <italic>p</italic> = 0.006) and a lower ejection fraction [56.6 (9.3) vs. 59.8 (7.5), <italic>p</italic> = 0.046]. Female patients were frailer at the time of the procedure [poor mobility rate, 26% vs. 11.7%, <italic>p</italic> &lt; 0.001; CCI (Charlson comorbidity index) 2.4 (0.67) vs. 2.32 (0.63), <italic>p</italic> = 0.04]. Despite these different risk profiles, no significant differences were reported in terms of post-procedural outcomes and long-term survival. Propensity score matching resulted in a good match of 204 patients in each group (57.9% of the entire study population). In the matched cohort, men had a significantly higher incidence of new pacemaker implantation compared to women [33 (16.2%) vs. 18 (8.8%)]. The Kaplan–Meier 5-year survival estimate was 82.4% for women and 72.1% for men, <italic>p</italic> = 0.038.</p></sec><sec><title>Conclusions</title><p>Female gender could be considered as a predictor of better outcomes after TAVI.</p></sec>