The Heart and Vascular Centre, Mount Elizabeth Medical Centre, Singapore
Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Open Heart. 2021 Jan;8(1). doi: 10.1136/openhrt-2020-001541.
Transcatheter aortic valve replacement (TAVR) is increasingly performed. Physically small Asians have smaller aortic root and peripheral vessel anatomy. The influence of gender of Asian patients undergoing TAVR is unknown and may affect outcomes. The aim of this study was to assess sex differences in Asian patients undergoing TAVR.
Patients undergoing TAVR from eight countries were enrolled. In this retrospective analysis, we examined differences in characteristics, 30-day clinical outcomes and 1-year survival between female and male Asian patients.
Eight hundred and seventy-three patients (54.4% women) were included. Women were older, smaller and had less coronary artery and lung disease but tended to have higher logistic EuroSCOREs. Smaller prostheses were used more often in women. Major vascular complications occurred more frequently in women (5.5% vs 1.8%, p<0.01); however, 30-day stroke and mortality (women vs men: 1.5% vs 1.6%, p=0.95% and 4.3% vs 3.4%, p=0.48) were similar. Functional status improvement was significant and comparable between the sexes. Conduction disturbance and permanent pacemaker requirements (11.2% vs 9.0%, p=0.52) were also similar as was 1-year survival (women vs men: 85.6% vs 88.2%, p=0.25). The only predictors of 30-day mortality were major vascular injury in women and age in men.
Asian women had significantly smaller stature and anatomy with some differences in clinical profiles. Despite more frequent major vascular complications, women had similar 30-day stroke or mortality rates. Functional status improvement was significant and comparable between the sexes. Conduction disturbance and permanent pacemaker requirements were similar as was 1-year survival.
经导管主动脉瓣置换术（TAVR）的应用日益增多。身材较小的亚洲人主动脉根部和外周血管解剖结构也较小。接受 TAVR 的亚洲患者的性别影响尚不清楚，可能会影响结果。本研究旨在评估接受 TAVR 的亚洲患者的性别差异。
从八个国家招募接受 TAVR 的患者。在这项回顾性分析中，我们检查了女性和男性亚洲患者的特征、30 天临床结局和 1 年生存率的差异。
共纳入 873 例患者（54.4%为女性）。女性年龄较大，体型较小，且患有较少的冠状动脉疾病和肺部疾病，但倾向于具有较高的 logistic EuroSCORE。女性更常使用较小的假体。女性更常发生主要血管并发症（5.5%比 1.8%，p<0.01）；然而，30 天卒中发生率和死亡率（女性比男性：1.5%比 1.6%，p=0.95% 和 4.3%比 3.4%，p=0.48）相似。功能状态改善在性别间具有显著差异且相似。传导障碍和永久性起搏器需求（11.2%比 9.0%，p=0.52）也相似，1 年生存率（女性比男性：85.6%比 88.2%，p=0.25）也相似。30 天死亡率的唯一预测因素是女性的主要血管损伤和男性的年龄。
亚洲女性的身材明显较小，解剖结构也较小，临床特征存在一些差异。尽管主要血管并发症更为常见，但女性的 30 天卒中或死亡率相似。功能状态改善在性别间具有显著差异且相似。传导障碍和永久性起搏器需求也相似，1 年生存率也相似。
