Wilczek Krzysztof, Chodór Piotr, Dyrbuś Maciej, Hawranek Michał, Włoch Łukasz, Pyka Łukasz, Hrapkowicz Tomasz, Zembala Michał, Kalarus Zbigniew, Gąsior Mariusz
3 Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland.
Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases in Zabrze, Poland.
Postepy Kardiol Interwencyjnej. 2020 Dec;16(4):436-443. doi: 10.5114/aic.2020.101769. Epub 2020 Dec 29.
Despite the establishment of multiple factors influencing short- and mid-term outcomes in patients treated with transcatheter aortic valve implantation (TAVI), the real-world data on the association between gender and outcomes after TAVI remain conflicting.
To evaluate the association of female gender with the clinical and periprocedural characteristics along with in-hospital, short- and medium-term outcomes of patients treated with TAVI in comparison with male patients.
Data from the prospective, single-centre registry of consecutive patients with severe AS referred for TAVI from 26 November 2008 to 31 December 2018 were analysed retrospectively. The study population comprised 275 patients who were divided by gender. The primary endpoint of the study was all-cause mortality at 1 year.
Women constituted 132 (48.0%) of the overall population. Women were significantly older, but had a significantly higher left ventricular ejection fraction (LVEF) and had less frequently undergone coronary artery bypass grafting (CABG) before TAVI. The implantation success rate was comparable between genders, but women less frequently required implantation of a pacemaker after TAVI, although they more frequently required blood transfusion due to severe bleeding. The primary endpoint occurred in 13.6% of women and 7.7% of men ( = 0.12).
Despite advanced age and prevalence of cardiovascular risk factors, the overall short- and medium-term mortality in patients treated with TAVI in our analysis of the real-world population remains relatively low. Although women seemed to have a slightly better clinical baseline profile, their in-hospital, 30-day, 6-month and 12-month outcomes did not differ significantly from the male patients.
尽管已经确定了多种影响经导管主动脉瓣植入术（TAVI）患者短期和中期预后的因素，但关于性别与TAVI术后预后之间关联的真实世界数据仍存在冲突。
评估女性与男性患者相比，在接受TAVI治疗的患者中，女性性别与临床和围手术期特征以及住院期间、短期和中期预后之间的关联。
回顾性分析2008年11月26日至2018年12月31日期间因严重主动脉瓣狭窄（AS）而接受TAVI治疗的连续患者的前瞻性单中心登记数据。研究人群包括275例按性别划分的患者。该研究的主要终点是1年时的全因死亡率。
女性占总人群的132例（48.0%）。女性年龄显著更大，但左心室射血分数（LVEF）显著更高，并且在TAVI术前较少接受冠状动脉旁路移植术（CABG）。性别之间的植入成功率相当，但女性在TAVI术后较少需要植入起搏器，尽管她们因严重出血而更频繁地需要输血。主要终点在13.6%的女性和7.7%的男性中出现（P = 0.12）。
尽管年龄较大且心血管危险因素普遍存在，但在我们对真实世界人群的分析中，接受TAVI治疗的患者总体短期和中期死亡率仍然相对较低。尽管女性似乎具有略好的临床基线特征，但她们的住院期间、30天、6个月和12个月的预后与男性患者相比并无显著差异。
