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October 19, 2017Cardiology in Review

Sex-Specific Outcomes After Transcatheter Aortic Valve Replacement: A Review of the Literature

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Key result

Female sex is linked to better survival after TAVR versus men despite more early complications.

Why the study?

Outcomes after transcatheter aortic valve replacement based on an individual's sex remain to be fully elucidated.

Do outcomes after transcatheter aortic valve replacement differ between women and men?

Population

Patients ineligible for or at high risk for surgery undergoing TAVR from 23 publications

Comparison

Women versus men after TAVR

Design

Literature review

Follow-up

30 days

Authors

YAYasameen AzarbaijaniKOKathryn M. O’CallaghanWSWilliam E. Sanders

Discussion

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Member takes

Overview

May support sex-specific TAVR risk discussions; leaves open mechanisms and need for prospective validation.

Structured PICO

Do outcomes after transcatheter aortic valve replacement differ between women and men?

P
Population
Review of 23 publications evaluating sex-specific outcomes in patients undergoing transcatheter aortic valve replacement.
E
Exposure
Transcatheter aortic valve replacement (TAVR)
C
Comparator
Comparison between women and men
O
Outcome
Survivalhard clinical

Main Result

Effect estimate: HR 0.27 to 0.91 (95% CI 0.09-0.84 to 0.75-1.10)

Following TAVR, women appear to have better survival than men but face higher risks of 30-day vascular and bleeding complications, which may be partly explained by differences in baseline comorbidities.

Limitations

  • Most measures only include unadjusted percentages

Cite This Study

Azarbaijani et al. (2017) conducted a review in Aortic valve replacement. Female sex vs. Male sex was evaluated on Survival (HR 0.27 to 0.91, 95% CI 0.09-0.84 to 0.75-1.10). Female sex was associated with better survival after TAVR compared to men (HR range 0.27 to 0.91), despite higher 30-day rates of vascular complications and bleeding.

synapsesocial.com/papers/6aa93ce41ed6af7fb80e0c7dhttps://doi.org/10.1097/crd.0000000000000177
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Influence of Sex on Outcome Following Transcatheter Aortic Valve Implantation (TAVI): Systematic Review and Meta‐Analysis2014 · 58 citations
  2. 2Revisiting Sex Equality With Transcatheter Aortic Valve Replacement Outcomes2015 · 247 citations
  3. 3Transcatheter Aortic-Valve Replacement with a Self-Expanding Prosthesis2014 · 2,919 citations
  4. 4Transcatheter Aortic-Valve Implantation for Aortic Stenosis in Patients Who Cannot Undergo Surgery2010 · 7,243 citations
  5. 5Left ventricular reverse remodeling after transcatheter aortic valve implantation: a cardiovascular magnetic resonance study2013 · 36 citations