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Forrest, John K., MD; Adams, David H., MD; Popma, Jeffrey J., MD; Reardon, Michael J., MD; Deeb, G. Michael, MD; Yakubov, Steven J., MD; Hermiller, James B., MD; Huang, Jian, MD; Skelding, Kimberly A., MD; Lansky, Alexandra, MD
The American journal of cardiology, 2016Journal Article
Abstract Treatment for severe symptomatic aortic stenosis has changed significantly in recent years due to advances in transcatheter aortic valve replacement (TAVR). Recent studies with the CoreValve prosthesis have demonstrated superior results as compared to surgical aortic valve replacement in patients at increased risk for surgery, but there are limited data on gender-related differences in patient characteristics and outcomes with this device. We compared baseline characteristics and clinical outcomes in women and men undergoing TAVR with the CoreValve prosthesis. A total of 3687 patients (1708 women, 1979 men) were included. At baseline women tended to be slightly older and to have increased frailty, but they had fewer cardiac comorbidities, higher left ventricular systolic function, less coronary artery disease, and fewer prior strokes. All-cause mortality was 5.9% for women and 5.8% for men at 30 days (P=0.87) and 24.1% and 21.3%, respectively, at 1 year (P=0.08). The incidence of stroke was 5.7% among women and 4.0% among men at 30 days (P=0.02) and 9.3% and 7.7%, respectively, at 1 year (P=0.05). Women had a higher incidence of bleeding, including more life-threatening bleeds, as well as a greater incidence of major vascular complications than men at 30 days. Device success was achieved in 86.9% of women and 86.1% of men (P=0.50). In conclusion, although there were significant baseline differences and procedure-related complications between women and men undergoing TAVR with the CoreValve prosthesis, this analysis found no significant difference in 30-day or 1-year mortality.
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