Sex‐Related Differences in 2197 Patients Undergoing Isolated Surgical Aortic Valve Replacement. Issue 6 (29th September 2014)

• Record Type: Journal Article
• Authors: Elhmidi, Yacine; Piazza, Nicolo; Mazzitelli, Domenico; Wottke, Michael; Lange, Rüdiger; Bleiziffer, Sabine
• Is Part Of: Journal of cardiac surgery. Volume 29:Issue 6(2014:Nov.)
• Page Start: 772
• Page End: 778
• Publication Date: 2014-09-29
• Subjects: Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.12442
• Languages: English
• ISSNs: 0886-0440

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="jocs12442-sec-0001" sec-type="section"> <title>Objectives</title> <p>The aim of this study is to evaluate gender‐related differences in clinical presentation and mortality in patients undergoing isolated surgical aortic valve replacement (SAVR).</p> </sec> <sec id="jocs12442-sec-0002" sec-type="section"> <title>Methods</title> <p>We performed a retrospective analysis of all patients undergoing isolated SAVR from 2000 to 2011 in our center. Patient data were compared with regard to gender including baseline characteristics, 30‐day, and late mortality. Kaplan–Meier survival curves were used to analyze long‐term survival up to 10 years follow‐up. Independent risk factors for 30‐day and late mortality were identified using a Cox regression model.</p> </sec> <sec id="jocs12442-sec-0003" sec-type="section"> <title>Results</title> <p>Two thousand one hundred ninety‐seven patients were included, 1290 (58.7%) male patients and 907 (41.3%) female patients. Female patients were older (70 ± 11 vs. 64 ± 13 years, p < 0.001), presented with higher logistic EuroSCORE (7.5 ± 5.8 vs. 5.6 ± 6%, p = 0.006), and more common NYHA class III or IV (71 vs. 65%, p = 0.05). Male patients presented more often with LV dysfunction (7.5 vs. 2.8%, p < 0.001) and endocarditis (4.1 vs. 1.7%, p < 0.001) than female patients. Intraoperatively, female patients were more likely to have had a complete sternotomy (65 vs. 52%, p < 0.001) and SAVR with a bioprosthesis (87 vs. 78%, p < 0.001). Female patients exhibited a higher 30‐day mortality (4.4 vs. 1.6%, p < 0.001) and late mortality (13 vs. 9.6%, p = 0.04) than male patients. After adjustment for baseline characteristics, only female gender was an independent predictor for 30‐day mortality (HR 2.2, 95% CI 0.98 to 5.2, p = 0.05) and age as independent predictor for late mortality (HR 1.07, 95% CI 1.03 to 1.1, p < 0.001).</p> </sec> <sec id="jocs12442-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Female patients were older and sicker and may therefore exhibit higher 30‐day and late mortality than male patients. Female gender per se was a predictor for 30‐day but not for late mortality. doi: 10.1111/jocs.12442 <italic>(J Card Surg 2014;29:772–778)</italic></p> </sec> </abstract>