After TAVI, men had higher pacemaker implantation (14.8% vs 12.6%, HR 1.24) but women had higher in-hospital mortality (1.8% vs 1.1%, HR for men 0.69).
Does male sex affect the risk of pacemaker implantation, ischemic stroke, and mortality in patients undergoing transcatheter aortic valve implantation?
Following TAVI, men have a higher risk of requiring a new pacemaker, whereas women face higher in-hospital and adjusted 30-day mortality.
Tasa de eventos absoluta: 0% vs 0%
Abstract Background Sex differences in outcomes after transcatheter aortic valve implantation (TAVI) are rarely described. Understanding these differences is key to optimizing care. Purpose To assess sex differences in pacemaker implantation, ischemic stroke, and mortality 30 days after TAVI. Methods Using Danish national registries, we identified patients undergoing first-time TAVI (2015–2023). Sex differences were analysed using Aalen-Johansen and Kaplan-Meier estimators, and Cox regression models. Results Among 7693 patients (58% men), men were more comorbid, while women were older (81.9 vs. 80.5 years) with longer hospital stays. Pacemaker implantation was more frequent in men at 30 days (14.8% vs. 12.6%, p=0.0073; adjusted HR 1.24, 95%CI 1.08-1.41). No sex differences were found for ischemic stroke at 30 days (males 2.2%, females 2.4%, p=0.58; adjusted HR 0.98, 95%CI 0.72-1.32). In-hospital mortality was higher for women (1.8% vs. 1.1%, p=0.023). Yet, no difference in the cumulative incidence of 30-days-mortality was observed (men 1.5%, women 2.0%, p=0.11), but in adjusted Cox Regression analysis, the mortality was lower for men (HR 0.69, 95%CI 0.49-0.99). Conclusions Sex-specific differences exist following TAVI – men having a higher incidence of new pacemaker implantation and women a higher in-hospital mortality. These findings highlight the need for sex-specific approaches to improve TAVI-outcomes.Figures 1A-C
Vistisen et al. (Sat,) reported a other. After TAVI, men had higher pacemaker implantation (14.8% vs 12.6%, HR 1.24) but women had higher in-hospital mortality (1.8% vs 1.1%, HR for men 0.69).