Sex differences in patients undergoing transcatheter aortic valve replacement in Asia.

Autor:	Chiam PTL; The Heart and Vascular Centre, Mount Elizabeth Medical Centre, Singapore paulchiam@heartvascularcentre.com., Hayashida K; Department of Cardiology, Keio University School of Medicine, Tokyo, Japan., Watanabe Y; Department of Cardiology, Teikyo University Hospital, Tokyo, Japan., Yin WH; Division of Cardiology, Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan., Kao HL; Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan., Lee MKY; Department of Cardiology, Queen Elizabeth Hospital, Hong Kong, Hong Kong., Posas FE; Department of Cardiology, St. Luke's Medical Centre, Manila, Philippines., Chandavimol M; Division of Cardiology, Ramathibodi Hospital, Bangkok, Thailand., Buddhari W; Medicine, Chulalongkorn University, Bangkok, Thailand., Dy TC; Heart Institute, Chinese General Hospital and Medical Centre, Manila, Philippines., Nguyen NQ; Department of Cardiology, Vietnam National Heart Institute, Hanoi, Vietnam., Kim WJ; Department of Cardiology, CHA Bundang Medical Centre, Seoul, Republic of Korea., Chang K; Cardiology, The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, Republic of Korea., Lin MS; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan., Lam YY; Hong Kong Asia Heart Centre, Canossa Hospital, Hong Kong, Hong Kong., Pham HM; Department of Cardiology, Vietnam National Heart Institute, Hanoi, Vietnam., Yahaya SA; Department of Cardiology, National Heart Institute, Kuala Lumpur, Malaysia., Ho KW; Department of Cardiology, National Heart Centre Singapore, Singapore., Pan W; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China., Liu XB; Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China., Wang J; Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China., Kim HS; Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea., Chen M; Department of Cardiology, Sichuan University West China Hospital, Chengdu, China.
Jazyk:	angličtina
Zdroj:	Open heart [Open Heart] 2021 Jan; Vol. 8 (1).
DOI:	10.1136/openhrt-2020-001541
Abstrakt:	Objectives: Transcatheter aortic valve replacement (TAVR) is increasingly performed. Physically small Asians have smaller aortic root and peripheral vessel anatomy. The influence of gender of Asian patients undergoing TAVR is unknown and may affect outcomes. The aim of this study was to assess sex differences in Asian patients undergoing TAVR. Methods: Patients undergoing TAVR from eight countries were enrolled. In this retrospective analysis, we examined differences in characteristics, 30-day clinical outcomes and 1-year survival between female and male Asian patients. Results: Eight hundred and seventy-three patients (54.4% women) were included. Women were older, smaller and had less coronary artery and lung disease but tended to have higher logistic EuroSCOREs. Smaller prostheses were used more often in women. Major vascular complications occurred more frequently in women (5.5% vs 1.8%, p<0.01); however, 30-day stroke and mortality (women vs men: 1.5% vs 1.6%, p=0.95% and 4.3% vs 3.4%, p=0.48) were similar. Functional status improvement was significant and comparable between the sexes. Conduction disturbance and permanent pacemaker requirements (11.2% vs 9.0%, p=0.52) were also similar as was 1-year survival (women vs men: 85.6% vs 88.2%, p=0.25). The only predictors of 30-day mortality were major vascular injury in women and age in men. Conclusions: Asian women had significantly smaller stature and anatomy with some differences in clinical profiles. Despite more frequent major vascular complications, women had similar 30-day stroke or mortality rates. Functional status improvement was significant and comparable between the sexes. Conduction disturbance and permanent pacemaker requirements were similar as was 1-year survival. Competing Interests: Competing interests: PTLC, KH, YW, W-HY, MKYL, MC, WJK, KC, M-SL and HSK have served as proctors for Edwards Lifesciences. PTLC, YW, W-HY, H-LK, MKYL, WB, Dy, KC, M-SL, KWH and HSK have served as proctors for Medtronic. WJK has served as a consultant for Medtronic. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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