Male sex was not associated with a significant difference in pre-procedural adverse outcomes compared to female sex in patients with severe aortic stenosis awaiting TAVI (25.5% vs. 24.2%, p=0.832).
Cohort (n=189)
No
Do pre-procedural outcomes differ between male and female patients with severe aortic stenosis awaiting TAVI?
Pre-procedural adverse outcomes do not differ between male and female patients awaiting TAVI, despite significant sex-related differences in CAD prevalence, ventricular geometry, and aortic valve area.
Absolute Event Rate: 25.5% vs 24.2%
p-value: p=0.832
Abstract Introduction Transcatheter aortic valve implantation (TAVI) is the preferred treatment for severe aortic stenosis (SAS) in older pts. However, due to limited availability, many pts face prolonged waiting times. Despite similar incidences between sexes, underlying pathophysiological mechanisms may differ. Identifying sex-related differences in pre-procedural outcomes may improve risk stratification, influence procedural aspects and enhance patient prognosis. Objectives We sought to characterize and compare pre-procedural outcomes between male and female pts with SAS awaiting TAVI. Methods Single-center retrospective cohort study of SAS pts who consecutively underwent pre-TAVI cardiac computed tomography (CCT) protocol between June 2022 and September 2024. Demographic and clinical data, transthoracic echocardiography (TTE), coronary angiography and CCT parameters were collected. The pre-procedural endpoint was a composite of cardiovascular (CV) hospitalization, all-cause mortality, and major adverse cardiovascular events (MACE), consisting of CV mortality, non-fatal acute myocardial infarction and stroke, whichever occurred first. Male (group A) and female (group B) pts were compared using SPSS v29. Results A total of 189 pts (mean age 81.2 ± 5 years) underwent pre-TAVI CCT during the study period and were divided in two groups - 98 males (group A) and 91 females (group B). No significant differences were observed between groups in terms of demographic or clinical characteristics (table 1), except for smoking, history of percutaneous coronary intervention and obstructive coronary artery (CAD) disease which were more frequent among male pts (21.4% vs. 1.1%, p0.001; 12.2% vs 3.3, p=0.023; 41.8% vs 15.4%, p0.001). Left ventricular ejection fraction was higher in females on both CCT (64.2% vs. 57.3%, p=0.002) and TTE (62.1% vs. 59.9%, p0.001). Females also exhibited significantly thinner septal and posterior wall thicknesses compared to males (p=0.003 and p=0.007, respectively), and a smaller aortic valve area (0.8 vs. 0.9 cm², p0.001). The mean time from CCT to TAVI was 8.7 ± 5.3 months, with no differences between groups. No significant differences were observed in pre-procedural outcomes between both groups (25.5% vs. 24.2%, p=0.832), including CV hospitalization (21.4% vs. 15.4%, p=0.377), MACE (5.1% vs. 4.4%, p=1.000), or all-cause mortality (9.2% vs. 12.1%, p=0.590). Conclusions In this cohort of pts with SAS awaiting TAVI, sex-related differences were observed in the prevalence of coronary artery disease and associated risk factors, ventricular geometry, and aortic valve functional area, as assessed by multimodal imaging. Although these differences may influence procedural planning, pre-procedural adverse outcomes did not differ between sexes.
Amado et al. (2026) conducted a cohort in Severe aortic stenosis (n=189). Male sex vs. Female sex was evaluated on Composite of cardiovascular hospitalization, all-cause mortality, and major adverse cardiovascular events (MACE) (p=0.832). Male sex was not associated with a significant difference in pre-procedural adverse outcomes compared to female sex in patients with severe aortic stenosis awaiting TAVI (25.5% vs. 24.2%, p=0.832).
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