Contemporary data on gender differences in outcomes after transcatheter aortic valve
implantation (TAVI), after stratification by age, remain limited. We studied age-stratified
(60 to 70, 71 to 80, and 81 to 90 years) inhospital outcomes by gender after TAVI
from the National Inpatient Sample database between 2012 and 2018. We analyzed National
Inpatient Sample data using the International Classification of Diseases, Clinical
Modification, Ninth Revision, and Tenth Revision claims codes. Between the years 2012
and 2018, a total of 188,325 weighted hospitalizations for TAVI were included in the
analysis. A total of 21,957 patients were included in the 60 to 70 age group (44%
females), 60,770 (45% females) in the 71 to 80 age group, and 105,580 (50% females)
in the 81 to 90 age groups, respectively. Propensity-matched inhospital mortality
rates were significantly higher for females than males for the age group of 81 to
90 years (3.0% vs 2.1%, p <0.01). Vascular complications and a need for blood transfusions
remained significantly higher for females on propensity-matched analysis across all
categories of ages. Conversely, acute kidney injury and the need for pacemaker implantation
remained significantly higher for males across all age groups. In conclusion, we report
that mortality is higher in female patients who underwent TAVI between the ages of
81 to 90. Moreover, the female gender was associated with higher vascular complications
and bleeding requiring transfusions. Conversely, the male gender was associated with
higher rates of pacemaker implantation and acute kidney injury.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Transcatheter versus surgical aortic-valve replacement in high-risk patients.N Engl J Med. 2011; 364: 2187-2198
- Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients.N Engl J Med. 2019; 380: 1695-1705
- 2020 ACC/AHA Guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines.J Am Coll Cardiol. 2021; 77: 450-500
- Sex differences in the utilization and outcomes of surgical aortic valve replacement for severe aortic stenosis.J Am Heart Assoc. 2017; 6e006370
- Sex-related differences in clinical presentation and outcome of transcatheter aortic valve implantation for severe aortic stenosis.J Am Coll Cardiol. 2012; 59: 566-571
- Sex-related differences in outcomes after transcatheter or surgical aortic valve replacement in patients with severe aortic stenosis: insights from the PARTNER trial (placement of aortic transcatheter valve).J Am Coll Cardiol. 2014; 63: 1522-1528
Agency for Healthcare Research and Quality. Overview of the national (nationwide) inpatient sample (NIS). Available at: https://www.hcup-us.ahrq.gov/nisoverview.jsp#about. Accessed on August 20, 2021.
Agency for Healthcare Research and Quality. Healthcare Cost and Utilization Project (HCUP). Introduction to the HCUP Nationwide Inpatient Sample (NIS) 2011. Available at: https://www.hcup-us.ahrq.gov/db/nation/nis/NIS_Introduction_2011.pdf. Accessed on XXX.
- Sex differences in transfemoral transcatheter aortic valve replacement.J Am Coll Cardiol. 2019; 74: 2758-2767
- Long-term outcomes with transcatheter aortic valve replacement in women compared with men: evidence from a meta-analysis.JACC Cardiovasc Intv. 2018; 11: 24-35
- Influence of gender on clinical outcomes following transcatheter aortic valve implantation from the UK transcatheter aortic valve implantation registry and the National Institute for Cardiovascular Outcomes Research.Am J Cardiol. 2014; 113: 522-528
- Sex-based differences in outcomes with transcatheter aortic valve therapy: TVT registry from 2011 to 2014.J Am Coll Cardiol. 2016; 68: 2733-2744
- Sex-specific in-hospital outcomes of transcatheter aortic valve replacement with third generation transcatheter heart valves.Catheter Cardiovasc Interv. 2021; 98: 176-183
- Sex differences in mortality and 90-day readmission rates after transcatheter aortic valve replacement (TAVR): A nationwide analysis from the United States.Eur Heart J Qual Care Clin Outcomes. 2021; https://doi.org/10.1093/ehjqcco/qcab012
- Sex-specific outcomes of transcatheter aortic valve replacement with the SAPIEN 3 valve: insights from the PARTNER II S3 high-risk and intermediate-risk cohorts.JACC Cardiovasc Interv. 2018; 11: 13-20
- Revisiting sex equality with transcatheter aortic valve replacement outcomes: a collaborative, patient-level meta-analysis of 11,310 patients.J Am Coll Cardiol. 2015; 66: 221-228
- Sex-specific differences at presentation and outcomes among patients undergoing transcatheter aortic valve replacement: a cohort study.Ann Intern Med. 2016; 164: 377-384
- Incidence, predictors, and impact of vascular complications after transfemoral transcatheter aortic valve implantation with the SAPIEN 3 prosthesis.Am J Cardiol. 2018; 121: 1231-1238
- Clinical outcomes and imaging findings in women undergoing TAVR.JACC Cardiovasc Imaging. 2016; 9: 483-493
- Predictors of permanent pacemaker implantation in patients undergoing transcatheter aortic valve replacement - a systematic review and meta-analysis.J Am Heart Assoc. 2021; 10e020906
- Predictors of permanent pacemaker implantation in patients with severe aortic stenosis undergoing TAVR: a meta-analysis.J Am Coll Cardiol. 2014; 64: 129-140
- Sex differences in cardiovascular outcome during progression of aortic valve stenosis.Heart. 2015; 101: 209-214
- Female sex reduces the risk of hospital-associated acute kidney injury: a meta-analysis.BMC Nephrol. 2018; 19: 314
- Predictors of acute kidney injury after transcatheter aortic valve implantation (from national inpatient sample [2011–2018].Am J Cardiol. 2021; 151: 120-122
- Evolution of outcome and complications in TAVR: a meta-analysis of observational and randomized studies.Sci Rep. 2020; 10: 15568
Article info
Publication history
Published online: January 03, 2022
Received in revised form:
November 21,
2021
Received:
September 5,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
