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Sex-differences and long-term outcomes after aortic valve replacement
Session:
SESSÃO DE POSTERS 17 - DIFERENÇAS ENTRE SEXOS NA MEDICINA CARDIOVASCULAR
Speaker:
ADRIANA VAZÃO
Congress:
CPC 2025
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.2 Cardiovascular Disease in Women
Session Type:
Cartazes
FP Number:
---
Authors:
Adriana Vazão; André Martins; Carolina Gonçalves; Joana Pereira; Mónica Amado; Mariana Carvalho; Margarida Cabral; João Carvalho; Catarina Ruivo; Sara Fernandes; Hélia Martins
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>Introduction: </strong>Aortic stenosis is the most common valvulopathy, with an increasing incidence attributed to rising life expectancy. While the incidence of severe aortic stenosis (SAS) does not differ between sexes, its pathophysiology varies. Identifying sex-related differences in long-term outcomes among patients (pts) undergoing aortic valve replacement (AVR) may enhance clinical awareness and improve patient prognosis.</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>Objective: </strong>To evaluate sex-related differences in clinical and echocardiographic predictors of long-term adverse events, in pts who underwent AVR. </span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>Methods: </strong>Retrospective cohort study of adult pts with SAS, diagnosed between January 2015 and August 2019, who underwent surgical AVR (SAVR) or transcatheter aortic valve implantation (TAVI). Demographic data, baseline clinical characteristics and transthoracic echocardiography (TTE) parameters at three time points: pre-procedure, short term post-procedure, and late post-procedure were collected. The median follow-up duration was 5 years. Long-term adverse events were defined as heart failure (HF) hospitalization or death from any cause after AVR during the follow-up period. Female pts (group 1) were compared to male pts (group 2). Statistical analysis was performed with SPSS v29.</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>Results: </strong>Ninety-five pts were included in the study, of whom 83 (87%) underwent SAVR and 12 (13%) underwent TAVI. Thirty-two pts (34%) were female (group 1). Baseline clinical characteristics were similar between groups, except for tobacco use, which was less common in women (1 (3%) vs 17 (27%), p=0.005). On baseline ECG, left ventricular hypertrophy criteria were less frequently observed in Group 1 (12 (39%) vs 36 (61%), p=0.004). Baseline laboratory analysis revealed lower hemoglobin levels (13±2 vs 14±2 g/dL, p=0.011), lower creatinine levels (median 66 vs 81μmol/L, p=0.002) and higher LDL cholesterol levels (114±35 vs 98±31mg/dL, p=0.039) in Group 1. Pre-procedural TTE parameters were largely similar between groups, except for a smaller aortic valve area in Group 1 (median 0.65 [0.51–0.79] vs. 0.85 [0.74–0.96]cm², p<0.001). However, this difference was not significant after adjustment for body surface area (0.41±0.11 vs. 0.43±0.08 cm²/m², p=0.431). Short-term post-procedural TTE (median 10 months) demonstrated improvement in aortic valve parameters in both groups. Nonetheless, Group 1 pts had a higher E/e’ ratio (median 15 vs. 12, p=0.029). Long-term follow-up TTE (median 41 months) revealed no significant differences between groups. Regarding long-term adverse events, 20 HF hospitalizations and 24 deaths were recorded, including 11 CV-related deaths, but no significant differences in adverse events were observed between groups (Fig. 1).</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>Conclusion: </strong>This retrospective study did not identify any sex-related differences in long-term outcomes in adult pts following AVR. </span></span></span></p>
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