Why the study?
Gender differences across age groups among patients undergoing transcatheter aortic valve implantation have not been well evaluated.
Does female gender affect early and medium-term outcomes compared to male gender in age-stratified patients undergoing TAVI?
Cohort (n=147,481)
Yes
Does female gender affect early and medium-term outcomes compared to male gender in age-stratified patients undergoing TAVI?
While early mortality and 30-day outcomes after TAVI are similar between genders, older women (≥70 years) face a higher risk of 6-month all-cause readmission.
Gender-age differences in TAVI outcomes from observational data are hypothesis-generating; leaves open targeted risk models and prospective confirmation.
Few researchers have discussed the differences in gender between the age groups of patients who underwent transcatheter aortic valve implantation (TAVI). We searched the National Readmissions Database from 2012 to 2019 to identify adults who underwent TAVI. We studied hospital outcomes and short- to medium-term outcomes by age stratification (18 to 59, 60 to 69, 70 to 79, and 80 to 90 years) after TAVI and categorized by gender. We included 147,481 patients who underwent TAVI, and 54,802 pairs were matched using propensity score matching separately for each age group. Compared with men, women in all age groups had a similar rate of hospital death. Except the 18- to 59-year-old groups, female patients were less likely to undergo permanent pacemaker implantation and transfusion. Records of readmission at 30 days and 6 months were used as the follow-up outcome according to the presence or absence of readmission. Major adverse cardiovascular events (MACEs) were a composite of cardiovascular readmission, all-cause mortality during readmission, and stroke readmission. At the 30-day follow-up visit, there was no difference in the all-cause readmission and MACE between women and men in any group. At the 6-month follow-up visit, women in the 70- to 79-year-old and 80- to 90-year-old groups had a high risk of all-cause readmission. In conclusion, we reported that female patients have similar in-hospital death rates to male patients who underwent TAVI. During the 30-day follow-up visit, the all-cause readmission and MACE were not different in all age groups between men and women. At 6 months, women in the 70- to 79-year-old and 80- to 90-year-old groups had a higher risk of all-cause readmission.
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Zhou et al. (2022) conducted a cohort in Transcatheter aortic valve implantation (TAVI) (n=147,481). Female gender vs. Male gender was evaluated on In-hospital death, all-cause readmission, and MACE.
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