What question did this study set out to answer?

To evaluate long-term, gender-stratified outcomes including 3-year mortality and hospital readmission rates in patients undergoing transcatheter aortic valve replacement (TAVR).

May 15, 2019Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery

Longitudinal Outcomes of Women Undergoing Transcatheter Aortic Valve Replacement

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Why the study?

Recent data suggested women have a survival benefit at 1-year follow-up after TAVR, but long-term gender-based TAVR outcomes were lacking.

Does female gender affect long-term mortality and readmissions in patients undergoing TAVR?

Population

1,036 patients undergoing isolated TAVR from 2011 to 2017

Comparison

Women vs men

Design

Cohort study

Follow-up

3 years

Authors

AKArman KilicHeart Failure / Cardiomyopathy VBValentino BiancoUniversidad Complutense de Madrid TGThomas G. GleasonInterventional / Structural Cardiology

Discussion

Member takes

Implication

3-year gender-specific TAVR outcomes remain uncertain; leaves open whether 1-year female survival benefit extends to 3 years.

Key Points

To evaluate long-term, gender-stratified outcomes including 3-year mortality and hospital readmission rates in patients undergoing transcatheter aortic valve replacement (TAVR).
Analyzed 1,036 consecutive patients (518 men and 518 women) who underwent isolated TAVR between 2011 and 2017.
Assessed primary endpoints of 3-year mortality and hospital readmissions using multivariable logistic regression to calculate risk-adjusted hazard ratios.
Operative 30-day mortality was 3.7% (17/518) for women versus 3.3% (15/518) for men (P=0.77), and 30-day readmissions were 12.2% (44/518) versus 10.8% (40/518; P=0.56).
Women received significantly more perioperative blood products (14.1% vs. 8.1%; P=0.002), while men had significantly higher rates of permanent pacemaker placement (11.6% vs. 7.0%; P=0.01).
Risk-adjusted multivariable analysis demonstrated gender was not associated with long-term mortality (HR 0.99, 95% CI 0.76–1.30; P=0.99) or hospital readmission (HR 0.90, 95% CI 0.72–1.14; P=0.42).

Structured PICO

Does female gender affect long-term mortality and readmissions in patients undergoing TAVR?

Population

1,036 patients undergoing isolated transcatheter aortic valve replacement (TAVR) from 2011 to 2017, divided into male (n=518) and female (n=518) cohorts.

Intervention

Female gender

Comparator

Male gender

Outcome

3-year mortality and 3-year hospital readmissionshard clinical

After risk adjustment, female gender is not associated with a significant difference in long-term survival or hospital readmissions following TAVR.

Limitations

Single-center study (implied by the stated need for multi-institutional data to validate findings)

Cite This Study

Kilic et al. (2019) studied this question.

synapsesocial.com/papers/6a8b92512448cb7c68338bda https://doi.org/10.1177/1556984519842943

Topics

Transcatheter aortic valve replacement TAVR in low-risk patients

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Longitudinal Outcomes of Women Undergoing Transcatheter Aortic Valve Replacement

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

Longitudinal Outcomes of Women Undergoing Transcatheter Aortic Valve Replacement

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider