Thevathasan Tharusan, Reitz Fabian, Hornig Constantin, Leistner David M, Dreger Henryk, Sündermann Simon, Mattig Isabel, Unbehaun Axel, Haghikia Arash, Skurk Carsten, Hinkov Hristian, Zirkelbach Berit, Stangl Karl, Falk Volkmar, Landmesser Ulf, Hindricks Gerhard, Stangl Verena, Brand Anna
Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Campus Benjamin Franklin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Berlin, Germany.
Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Campus Mitte, Berlin, Germany.
JACC Adv. 2025 Jul 18;4(8):102012. doi: 10.1016/j.jacadv.2025.102012.
Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic valve stenosis. Data regarding sex-specific differences in patient-centered endpoints, such as patient-reported outcomes (PROs), and in sociodemographic characteristics are scarce.
This study aimed to investigate patient-centered, sex-specific characteristics and their associations with the overall patient outcome, that is, clinical course and PROs in patients undergoing TAVI.
This analysis of the TAVI-COMIC randomized controlled trial included 299 patients undergoing TAVI at 2 tertiary care centers. Data were collected for sociodemographic characteristics, PROs, and postprocedural outcomes for up to 90 days.
Male patients undergoing TAVI had significantly higher educational attainment with more university degrees (34.2% vs 13.0%, P < 0.001). Female patients were significantly less often in a relationship (29.7% vs 73.3%, P < 0.001). Females reported significantly higher anxiety levels before TAVI (State-Trait Anxiety Inventory: 42 vs 39 points, P < 0.001). Postprocedure, female patients experienced longer hospital stays (8 vs 7 days) and reported greater difficulties with daily activities such as walking (41.7% vs 29.8%), shopping (41.7% vs 27.2%), helplessness (35.7% vs 10.5%), and depression (45.2% vs 25.4%). Female patients were more frequently discharged to a nursing facility (11.6% vs 3.7%).
This study highlights significant sex-specific differences in educational and relationship status, anxiety levels, as well as length of hospitalization and PROs following TAVI. Female patients showed higher anxiety and more frequent postprocedural challenges. These findings underscore the need for tailored pre- and post-procedural care to address the distinct needs of male and female TAVI patients.
经导管主动脉瓣植入术（TAVI）是治疗严重主动脉瓣狭窄的既定疗法。关于以患者为中心的终点指标（如患者报告结局[PROs]）以及社会人口学特征方面性别差异的数据很少。
本研究旨在调查以患者为中心的、性别特异性特征及其与TAVI患者总体结局（即临床病程和PROs）的关联。
对TAVI - COMIC随机对照试验的这项分析纳入了299例在2个三级医疗中心接受TAVI的患者。收集了社会人口学特征、PROs以及术后长达90天的结局数据。
接受TAVI的男性患者教育程度显著更高，拥有大学学位的比例更高（34.2%对13.0%，P<0.001）。女性患者处于恋爱关系中的比例显著更低（29.7%对73.3%，P<0.001）。女性在TAVI术前报告的焦虑水平显著更高（状态 - 特质焦虑量表：42分对39分，P<0.001）。术后，女性患者住院时间更长（8天对7天），并且在诸如行走（41.7%对29.8%）、购物（41.7%对27.2%）、无助感（35.7%对10.5%）和抑郁（45.2%对25.4%）等日常活动方面报告有更大困难。女性患者更频繁地被转至护理机构（11.6%对3.7%）。
本研究突出了在教育和恋爱状况、焦虑水平以及TAVI术后住院时间和PROs方面存在显著的性别差异。女性患者表现出更高的焦虑以及更频繁的术后挑战。这些发现强调了需要进行针对性的术前和术后护理，以满足男性和女性TAVI患者的不同需求。
