Sex Differences in Clinical and Patient-Reported Outcomes in Transcatheter Aortic Valve Implantation

BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic valve stenosis. Data regarding sex-specific differences in patient-centered endpoints, such as patient-reported outcomes (PROs), and in sociodemographic characteristics are scarce. OBJECTIVES: This study aimed to investigate patient-centered, sex-specific characteristics and their associations with the overall patient outcome, that is, clinical course and PROs in patients undergoing TAVI. METHODS: This analysis of the TAVI-COMIC randomized controlled trial included 299 patients undergoing TAVI at 2 tertiary care centers. Data were collected for sociodemographic characteristics, PROs, and postprocedural outcomes for up to 90 days. RESULTS: Male patients undergoing TAVI had significantly higher educational attainment with more university degrees (34.2% vs 13.0%, P < 0.001). Female patients were significantly less often in a relationship (29.7% vs 73.3%, P < 0.001). Females reported significantly higher anxiety levels before TAVI (State-Trait Anxiety Inventory: 42 vs 39 points, P < 0.001). Postprocedure, female patients experienced longer hospital stays (8 vs 7 days) and reported greater difficulties with daily activities such as walking (41.7% vs 29.8%), shopping (41.7% vs 27.2%), helplessness (35.7% vs 10.5%), and depression (45.2% vs 25.4%). Female patients were more frequently discharged to a nursing facility (11.6% vs 3.7%). CONCLUSIONS: This study highlights significant sex-specific differences in educational and relationship status, anxiety levels, as well as length of hospitalization and PROs following TAVI. Female patients showed higher anxiety and more frequent postprocedural challenges. These findings underscore the need for tailored pre- and post-procedural care to address the distinct needs of male and female TAVI patients.