Gender disparities in the treatment of aortic stenosis – an analysis of the united states national inpatient sample (2009–2018)

Autor: I Erinne, V Bhasin, N Parikh, E Hiltner, C Chen, M J Russo, J Kassotis, A Sethi
Rok vydání: 2021
Předmět:
Zdroj: European Heart Journal. 42
ISSN: 1522-9645
0195-668X
Popis: Introduction Gender disparity in the management of a variety of cardiovascular disorders has been well established. Studies have shown that women are less likely to undergo surgical aortic valve replacement (SAVR), and have higher mortality and health care cost in the management of aortic stenosis (AS). The impact of transcatheter aortic valve replacement (TAVR) on this gender disparity has not been well established. Purpose We sought to examine the impact of gender on outcomes following aortic valve replacement for AS in the era of routine transcatheter valve replacement. Methods We used the National Inpatient Sample (2009–18), a representative probability sample of the United States, to study visits for all aortic valve replacements and in-hospital outcomes as a function of gender. Survey estimation commands were used to provide national estimates. Results There were an estimated 431,344 SAVR and 189,137 TAVR inpatient visits during the periods of 2009–18 and 2011–18, respectively with a higher representation of women in the TAVR cohort (46.4% [95% CI, 45.9%-46.9%]) than SAVR (36.8% [95% CI, 36.4%-37.2%]). Women were slightly older with higher prevalence of uncomplicated hypertension (HTN) and pulmonary circulation disorders. However, women exhibited a lower prevalence of complicated HTN, complicated diabetes mellitus, prior percutaneous coronary intervention, prior coronary artery bypass grafting, peripheral vascular disease and renal failure. In-hospital mortality was higher in women after SAVR (3.8%±0.1 vs 2.7%±0.07, p Conclusions TAVR appears to have narrowed the gender disparity in the management of AS. Although women continue to have a higher in-hospital mortality following both TAVR and SAVR compared to men, TAVR is associated with a lower inpatient mortality in women compared to SAVR. Thus, TAVR may represent a bridge for the gender gap in aortic valve replacement. Funding Acknowledgement Type of funding sources: None.
Databáze: OpenAIRE
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