AUTHOR=Lodo Vittoria , Italiano Enrico G. , Weltert Luca , Zingarelli Edoardo , Perrucci Chiara , Pietropaolo Claudio , Buono Gabriella , Centofanti Paolo 

TITLE=The influence of gender on outcomes following transcatheter aortic valve implantation

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1417430

DOI=10.3389/fcvm.2024.1417430

ISSN=2297-055X

ABSTRACT=Objectives: This study sought to compare gender-related differences in short-and long-term outcomes after transcatheter aortic valve implantation.Methods: Patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) from 09/2017 to 12/2022 were enrolled. The primary endpoint was 5-year all-cause mortality. The secondary endpoints were: 30-day mortality and the incidence of post-procedural complication. Patients were separated according to gender before statistical analysis. To compare patients with similar baseline characteristics a propensity matching was performed.Results: 704 patients (females: 361 [51,3%]; males: 343 [48,7%]) were enrolled. Compare to women, men had a higher incidence of smoking (40,5% vs 14,7%, p< 0,001), diabetes (32,9% vs 25,1%, p< 0,025), peripheral artery disease (35,8% vs 18,3%, p <0,001), previous cardiac surgery ( 13,7% vs 7,2%, p= 0,006),and a lower ejection fraction (56,6 [9,3] vs 59,8 [7,5], p=0,046). Female patients were frailer at the time of the procedure (poor mobility rate 26% vs 11,7%, p value<0,001, (CCI [Charlson comorbidity index] 2,4 [0,67] vs 2 ,32 [0,63, p=0,04]). Despite these different risk profiles, no significant differences were reported in terms of post procedural outcomes and long-term survival. Propensity score matching resulted in a good match of 204 patients in each group (57,9% of the entire study population). In the matched cohort men had a significantly higher incidence of new pace-maker implantation compared to women (33 [16,2%] vs 18 [8,8%]. The Kaplan-Meier 5-year survival estimate was 82,4% for women and 72,1% for men, p= 0,038.Conclusions: Female gender could be considered as a predictor of better outcomes after TAVI.