Sex differences in patients undergoing transcatheter aortic valve replacement in Asia.

Content Provider	Europe PMC
Author	Chiam, Paul T L Hayashida, Kentaro Watanabe, Yusuke Yin, Wei-Hsian Kao, Hsien-Li Lee, Michael K Y Posas, Fabio Enrique Chandavimol, Mann Buddhari, Wacin Dy, Timothy C Nguyen, Ngoc Quang Kim, Won Jang Chang, Kiyuk Lin, Mao-Shin Lam, Yat-Yin Pham, Hung Manh Yahaya, Shaiful Azmi Ho, Kay Woon Pan, Wenzhi Liu, Xian-bao Wang, Jian'an Kim, Hyo Soo Chen, Mao
Copyright Year	2021
Abstract	ObjectivesTranscatheter 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.MethodsPatients 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.ResultsEight 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.ConclusionsAsian 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.
Journal	Open Heart
Volume Number	8
PubMed Central reference number	PMC7798412
Issue Number	1
PubMed reference number	33419935
e-ISSN	20533624
DOI	10.1136/openhrt-2020-001541
Language	English
Publisher	BMJ
Publisher Date	2021-01-01
Publisher Place	BMA House, Tavistock Square, London, WC1H 9JR
Access Restriction	Open
Rights License	This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Subject Keyword	transcatheter aortic valve replacement aortic valve stenosis heart valve prosthesis implantation
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine