Four‐year mortality in women and men after transfemoral transcatheter aortic valve implantation using the SAPIEN 3. Issue 5 (4th September 2020)

• Record Type: Journal Article
• Authors: Tarantini, Giuseppe; Baumgartner, Helmut; Frank, Derk; Husser, Oliver; Bleiziffer, Sabine; Rudolph, Tanja; Jeger, Raban; Fraccaro, Chiara; Hovorka, Tomas; Wendler, Olaf
• Is Part Of: Catheterization and cardiovascular interventions. Volume 97:Issue 5(2021)
• Page Start: 876
• Page End: 884
• Publication Date: 2020-09-04
• Subjects: gender -- mortality rate -- predictors of mortality -- sex differences -- transcatheter aortic valve implantation; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.29257
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Objectives: To investigate 4‐year, post‐transcatheter aortic valve implantation (TAVI) survival and predictors of survival by sex, in a real‐world cohort that underwent transfemoral TAVI with SAPIEN 3 transcatheter heart valve. Background: Previous TAVI investigations of first‐generation devices demonstrated an early‐ to mid‐term survival advantage in women compared with men. Methods: SOURCE 3 (SAPIEN 3 Aortic Bioprosthesis European Outcome) is a post‐approval, multicentre, observational registry. Patients ( N = 1, 694, 49.2% women, age 81.7 ± 6.7 years) with severe aortic stenosis and high surgical risk (logistic EuroSCORE 17.8%) underwent TAVI between 2014 and 2015. Kaplan–Meier event estimates were used to determine mortality by sex. Predictors of overall mortality were identified using a cox multivariate proportional hazard model. Results: At 4 years, women had lower all‐cause mortality than men (36.0 vs 39.7%; p = .0911; HR: 0.87 [95% CI: 0.75–1.02]). No difference was observed for cardiac mortality between women 24.2% and men 24.7% ( p = .76; HR: 0.97 [95% CI: 0.79–1.19]). When adjusted for baseline characteristics (age, height, weight, NYHA functional class, renal insufficiency, EuroScore, and tricuspid regurgitation), sex had no impact on mortality. Conclusions: In this large, real‐world cohort, all‐cause mortality trended lower in women than men at 4 years post TAVI; however, several baseline factors, but not sex, were predictors of mortality. No difference between sexes was observed for cardiovascular mortality.