Women with severe aortic stenosis experienced longer delays from symptom onset to diagnosis (3 vs 1 months, p<0.001), but clinical outcomes post-TAVI were similar to men.
Does patient sex affect diagnostic and therapeutic delays or clinical outcomes in patients with severe symptomatic aortic stenosis referred for TAVI?
Despite women facing longer diagnostic delays and presenting with higher surgical risk and more advanced symptoms, clinical outcomes after TAVI are comparable between sexes.
Absolute Event Rate: 0% vs 0%
Abstract Background Gender-related disparities in diagnosis and referral to transcatheter aortic valve implantation (TAVI) remain incompletely understood. Aims This study aims to assess sex-related differences in diagnostic and therapeutic delays to TAVI and to explore sex-related disparities in management and clinical characteristics of patients with severe aortic stenosis (AS). Methods and results This multicentre, observational study included 519 patients (46.1% women) with severe symptomatic AS referred for TAVI in 2023 across three European centres. Outcomes were assessed according to VARC-3. Female-specific clinical history was systematically collected. Women were older, with higher surgical risk (STS Score: 4.5 3.0-6.6 vs 2.8 1.7-4.0, p0.001) and more advanced symptoms (NYHA functional class III-IV 87 vs 77,p=0.014). Aortic annulus dimensions and valve area were smaller in women (both p0.001). Women experienced longer delays from symptom onset to diagnosis (3 0-9 vs 1 0-4 months, p0.001), with notable inter-centre variability. However, time from diagnosis to TAVI was similar (3 1-5 vs 2.5 1-4.5 months, p=0.220). In-hospital mortality (2.5% vs 1.8%, p=0.555), bleeding, major vascular complications and conduction disturbances did not differ by sex. At six months functional status improved significantly; mortality (4.1% vs 5.3%, p=0.685), rehospitalisation and device success (84.6% vs 85.8%, p=0.252) were comparable between sexes. Female-specific characteristics, including pregnancy, gynaecological history and hormone therapy, were not significantly associated with clinical outcomes. Conclusions Women faced longer diagnostic delays, indicating persistent sex-based disparities in timely recognition of severe AS. Nevertheless, clinical outcomes after TAVI were similar between sexes supporting comparable treatment effectiveness.
Cascone et al. (Fri,) reported a other. Women with severe aortic stenosis experienced longer delays from symptom onset to diagnosis (3 vs 1 months, p<0.001), but clinical outcomes post-TAVI were similar to men.