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Gender differences and mortality trends after transcatheter aortic valve implantation: a 10-year analysis from a single tertiary centre
Session:
Posters - H. Interventional Cardiology and Cardiovascular Surgery
Speaker:
Cláudia Jesus Silva
Congress:
CPC 2021
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Posters
FP Number:
---
Authors:
Cláudia Jesus Silva; Mariana Gonçalves; Rui Campante Teles; Pedro de Araújo Gonçalves; Manuel de Sousa Almeida; Afonso Félix Oliveira; João Brito; Luís Raposo; Henrique Mesquita Gabriel; Tiago Nolasco; José Neves; Miguel Mendes
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif">Aim:</span></span></strong><span style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif"> To evaluate gender differences and mortality trends in a population undergoing transcatheter aortic valve implantation (TAVI); to analyze the correlates to all-cause mortality at follow up.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif">Methods:</span></span></strong><span style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif"> <span style="color:black">Prospective cohort of 592 TAVI patients (53.4% being female) treated between 2008 and 2018. Mortality differences between genders at different timepoints were assessed according to Log Rank test. Predictors of all-cause mortality at follow up were identified using a univariate model and were then analyzed through </span>multivariate Cox proportional hazard models<span style="color:black">.</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif">Results:</span></span></strong><span style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif"> Unlike females, male patients were younger<span style="color:black"> (</span></span></span><span style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif">81 ± 7.5</span></span><span style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif"><span style="color:black"> vs </span></span></span><span style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif">84.3 ± 5.3</span></span><span style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif"><span style="color:black">) and presented more comorbidities. Twelve female and eight male </span></span></span><span style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif">(3.5%) patients died in the first 30 days after TAVI. Despite a higher STS score in women, </span></span><span style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif">a</span></span><span style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif">ll-cause mortality rates at 30 days and at 1 year were comparable. <span style="color:black">At long term follow up, </span>female patients demonstrated better survival rates, even despite a higher number of periprocedural complications. Correlates identified in men were the presence of diabetes and previous history of CABG, NYHA class III/IV, PASP and non-transfemoral access. None of these variables remained significant in the multivariable analysis. In female only peripheral artery disease was associated with mortality. Shock and need for renal replacement were predictors of mortality in both genders, as it was heart failure re-admission after discharge. STS also showed to correlate to long term mortality in both genders.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif">Conclusion:</span></span></strong><span style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif"> Despite a higher STS score in women, 30-day mortality was not significantly different from male, while at long term follow-up, women present better clinical outcomes. </span></span></span></span></p>
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