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March 15, 2022Cardiology in Review

Sex-Related Differences in Postoperative Outcomes After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis

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Key result

Female sex in TAVR was associated with lower rates of acute kidney injury (P=0.05) and pacemaker insertion (P<0.00001), but higher rates of mortality, stroke, bleeding, and vascular complications.

Why the study?

Are there sex-related differences in postoperative outcomes between males and females undergoing transcatheter aortic valve replacement?

Population

Patients undergoing transcatheter aortic valve replacement from 28 retrospective and prospective studies

Comparison

Female sex vs Male sex

Design

Meta-analysis

Follow-up

in-hospital / postoperative

Discussion

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Member takes

Overview

May support sex-specific TAVR risk counseling; leaves open mechanisms and mitigation strategies for female-specific complications.

Study Design

Type

Meta-Analysis

Structured PICO

Are there sex-related differences in postoperative outcomes between males and females undergoing transcatheter aortic valve replacement?

P
Population
28 retrospective and prospective studies comparing outcomes between males and females undergoing transcatheter aortic valve replacement.
E
Exposure
Female sex
C
Comparator
Male sex
O
Outcome
Postoperative outcomes including acute kidney injury, pacemaker insertion, in-hospital mortality, stroke, bleeding complications, and vascular complicationshard clinical

In patients undergoing TAVR, females have lower rates of AKI and pacemaker insertion but higher rates of in-hospital mortality, stroke, bleeding, and vascular complications compared to males.

Limitations

  • Causal factors for sex differences remain unidentified
  • Lack of matching based on preoperative characteristics and follow-up data on ventricular remodeling and prosthetic valve performance
  • Causal factors for sex differences are unidentified
  • Lack of matching based on preoperative characteristics
  • Lack of follow-up data on postoperative ventricular remodeling and prosthetic valve performance

Cite This Study

A 2022 study conducted a meta-analysis in Aortic stenosis. Female sex vs. Male sex was evaluated on Postoperative outcomes including acute kidney injury, pacemaker insertion, in-hospital mortality, stroke, bleeding, and vascular complications. Female sex in TAVR was associated with lower rates of acute kidney injury (P=0.05) and pacemaker insertion (P<0.00001), but higher rates of mortality, stroke, bleeding, and vascular complications.

synapsesocial.com/papers/6ab1ca7a3e22bde53c1dca6dhttps://doi.org/10.1097/crd.0000000000000448
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Also Consider

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

  1. 1Sex-Related Differences in Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis2014 · 199 citations
  2. 2Sex and Transcatheter Aortic Valve Implantation: Impact of Female Sex on Clinical Outcomes2019 · 14 citations
  3. 3Gender‐related differences on short‐ and long‐term outcomes of patients undergoing transcatheter aortic valve implantation2016 · 44 citations
  4. 4Sex-related differences in clinical outcomes and quality of life after transcatheter aortic valve implantation for severe aortic stenosis2017 · 12 citations
  5. 5Sex differences in patients undergoing transcatheter aortic valve replacement in Asia2021 · 19 citations