WIN海湾经导管主动脉瓣置换术注册研究:描述患者特征、预后和结局方面的性别差异。

WIN Gulf TAVR Registry: Describing Sex Differences in Patient Characteristics, Prognosis, and Outcomes.

作者信息

Alasnag Mirvat, Alanazi Nouf, Al-Shaikh Shereen, AlMerri Khaled, Almoghairi Abdulrahman, Alenezi Abdullah, AlHarbi Waleed, Amin Haitham, Noor Hussam, Bardooli Fawaz, Al Lawati Hatim, Al Faraidy Khalid, AlShehri Mohammed, Thabane Michael, Thabane Lehana, Al-Shaibi Khaled

机构信息

Cardiac Center, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia.

Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

出版信息

J Soc Cardiovasc Angiogr Interv. 2022 Oct 15;1(6):100509. doi: 10.1016/j.jscai.2022.100509. eCollection 2022 Nov-Dec.

Abstract

BACKGROUND

Several international registries have examined outcomes in women undergoing transcatheter aortic valve replacement (TAVR). However, none of these studies included women from the Gulf region. The Women IN Gulf Transcatheter Aortic Valve Replacement (WIN Gulf TAVR) registry aimed to examine sex-based differences in patient characteristics and outcomes in patients undergoing TAVR in the region.

METHODS

This registry is a prespecified subanalysis of the main Gulf TAVR registry. Baseline characteristics, procedural details and success, and 1-year outcomes were recorded. The primary outcome consisted of a composite of all causes of death, myocardial infarction (MI), and rehospitalizations at 1 year. The secondary outcomes were a composite of the individual components of the primary composite.

RESULTS

A total of 347 women (44% of the Gulf TAVR registry) were included in the final analysis, with a mean age of 74.1 ± 9.1 years; mean ejection fraction of 56.20% ± 10.52%; and mean Society of Thoracic Surgeons score of 5.30 ± 4.35. The composite primary end point occurred in 12.4% (95% CI, 9.3-16.2). The individual components of the primary end point were as follows: death, 4.3% (95% CI, 2.6-7.0); MI, 1.1% (95% CI, 0.4-2.9); and rehospitalization, 9.8% (95% CI, 7.1-13.3), with 7.2% (95% CI, 4.9-10.4) related to cardiac causes.

CONCLUSIONS

Women in the WIN Gulf TAVR registry had outcomes and baseline characteristics similar to men. Although higher rehospitalizations for cardiac causes and MI at 1 year in women were noted, the overall survival was better in women. These observations warrant a larger cohort to identify the drivers of events.

摘要

背景

多个国际登记处已对接受经导管主动脉瓣置换术(TAVR)的女性患者的预后进行了研究。然而,这些研究均未纳入来自海湾地区的女性。海湾地区经导管主动脉瓣置换术女性患者登记处(WIN Gulf TAVR)旨在研究该地区接受TAVR治疗的患者在特征和预后方面基于性别的差异。

方法

该登记处是对主要海湾地区TAVR登记处预先设定的亚分析。记录了基线特征、手术细节及成功率以及1年的预后情况。主要结局包括1年时所有死因、心肌梗死(MI)和再次住院的综合情况。次要结局是主要综合结局各单项的综合情况。

结果

最终分析纳入了347名女性(占海湾地区TAVR登记处的44%),平均年龄为74.1±9.1岁;平均射血分数为56.20%±10.52%;平均胸外科医师协会评分为5.30±4.35。主要复合终点事件发生率为12.4%(95%CI,9.3 - 16.2)。主要终点各单项如下:死亡,4.3%(95%CI,2.6 - 7.0);MI,1.1%(95%CI,0.4 - 2.9);再次住院,9.8%(95%CI,7.1 - 13.3),其中7.2%(95%CI,4.9 - 10.4)与心脏原因有关。

结论

WIN Gulf TAVR登记处的女性患者的预后和基线特征与男性相似。虽然女性在1年时因心脏原因和MI再次住院率较高,但女性的总体生存率更好。这些观察结果需要更大规模的队列研究来确定事件的驱动因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3541/11307566/ff7db3fcec8e/fx1.jpg

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