Comparison of variables in men versus women undergoing transcatheter aortic valve implantation for severe aortic stenosis (from Italian Multicenter CoreValve Registry)

Paolo Buja, Massimo Napodano, Corrado Tamburino, Anna Sonia Petronio, Federica Ettori, Gennaro Santoro, Gian Paolo Ussia, Silvio Klugmann, Francesco Bedogni, Angelo Ramondo, Francesco Maisano, Antonio Marzocchi, Arnaldo Poli, Valeria Gasparetto, David Antoniucci, Antonio Colombo, Giuseppe Tarantini

Research output: Contribution to journalArticle

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Abstract

Although transcatheter aortic valve implantation (TAVI) for severe aortic stenosis is becoming an established technique, the effect of gender-related differences is poorly described. We performed a gender-based comparison of high-risk patients undergoing TAVI with the self-expandable CoreValve Revalving System for severe aortic stenosis to evaluate early and mid-term clinical outcomes. From the Italian prospective CoreValve registry, 659 consecutive patients (55.8% women) who underwent TAVI were included in the present study. We analyzed the gender-based differences in terms of clinical, angiographic, and procedural features and the differences in the rate of early and mid-term major adverse cardiac and cerebrovascular events. The men were younger, presented more often with severe left ventricular dysfunction, and had a greater rate of previous myocardial infarction, coronary revascularization, peripheral artery disease, renal failure, and heart conduction disorders than the women. The logistic European System for Cardiac Operative Risk Evaluation score did not differ between the 2 groups. The overall unadjusted and adjusted analyses failed to show significant differences between genders in terms of major adverse cardiac and cerebrovascular events at a median follow-up of 13 months (range 8 to 18). At late follow-up (landmark analysis >12 months), a survival benefit was observed in women (hazard ratio 0.27, 95% confidence interval 0.09 to 0.84, p = 0.02). In conclusion, in this multicenter registry, the gender-based comparison of TAVI patients showed that men, despite the younger age, had more extensive atherosclerotic burden compared to women. Overall, the early and mid-term outcomes were similar between genders, although women might have a survival benefit with longer follow-up.

Original languageEnglish
Pages (from-to)88-93
Number of pages6
JournalThe American Journal of Cardiology
Volume111
Issue number1
DOIs
Publication statusPublished - Jan 1 2013

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Aortic Valve Stenosis
Registries
Survival
Peripheral Arterial Disease
Left Ventricular Dysfunction
Renal Insufficiency
Myocardial Infarction
Transcatheter Aortic Valve Replacement
Confidence Intervals

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Comparison of variables in men versus women undergoing transcatheter aortic valve implantation for severe aortic stenosis (from Italian Multicenter CoreValve Registry). / Buja, Paolo; Napodano, Massimo; Tamburino, Corrado; Petronio, Anna Sonia; Ettori, Federica; Santoro, Gennaro; Ussia, Gian Paolo; Klugmann, Silvio; Bedogni, Francesco; Ramondo, Angelo; Maisano, Francesco; Marzocchi, Antonio; Poli, Arnaldo; Gasparetto, Valeria; Antoniucci, David; Colombo, Antonio; Tarantini, Giuseppe.

In: The American Journal of Cardiology, Vol. 111, No. 1, 01.01.2013, p. 88-93.

Research output: Contribution to journalArticle

Buja, P, Napodano, M, Tamburino, C, Petronio, AS, Ettori, F, Santoro, G, Ussia, GP, Klugmann, S, Bedogni, F, Ramondo, A, Maisano, F, Marzocchi, A, Poli, A, Gasparetto, V, Antoniucci, D, Colombo, A & Tarantini, G 2013, 'Comparison of variables in men versus women undergoing transcatheter aortic valve implantation for severe aortic stenosis (from Italian Multicenter CoreValve Registry)', The American Journal of Cardiology, vol. 111, no. 1, pp. 88-93. https://doi.org/10.1016/j.amjcard.2012.08.051
Buja, Paolo ; Napodano, Massimo ; Tamburino, Corrado ; Petronio, Anna Sonia ; Ettori, Federica ; Santoro, Gennaro ; Ussia, Gian Paolo ; Klugmann, Silvio ; Bedogni, Francesco ; Ramondo, Angelo ; Maisano, Francesco ; Marzocchi, Antonio ; Poli, Arnaldo ; Gasparetto, Valeria ; Antoniucci, David ; Colombo, Antonio ; Tarantini, Giuseppe. / Comparison of variables in men versus women undergoing transcatheter aortic valve implantation for severe aortic stenosis (from Italian Multicenter CoreValve Registry). In: The American Journal of Cardiology. 2013 ; Vol. 111, No. 1. pp. 88-93.
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AU - Petronio, Anna Sonia

AU - Ettori, Federica

AU - Santoro, Gennaro

AU - Ussia, Gian Paolo

AU - Klugmann, Silvio

AU - Bedogni, Francesco

AU - Ramondo, Angelo

AU - Maisano, Francesco

AU - Marzocchi, Antonio

AU - Poli, Arnaldo

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AU - Antoniucci, David

AU - Colombo, Antonio

AU - Tarantini, Giuseppe

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N2 - Although transcatheter aortic valve implantation (TAVI) for severe aortic stenosis is becoming an established technique, the effect of gender-related differences is poorly described. We performed a gender-based comparison of high-risk patients undergoing TAVI with the self-expandable CoreValve Revalving System for severe aortic stenosis to evaluate early and mid-term clinical outcomes. From the Italian prospective CoreValve registry, 659 consecutive patients (55.8% women) who underwent TAVI were included in the present study. We analyzed the gender-based differences in terms of clinical, angiographic, and procedural features and the differences in the rate of early and mid-term major adverse cardiac and cerebrovascular events. The men were younger, presented more often with severe left ventricular dysfunction, and had a greater rate of previous myocardial infarction, coronary revascularization, peripheral artery disease, renal failure, and heart conduction disorders than the women. The logistic European System for Cardiac Operative Risk Evaluation score did not differ between the 2 groups. The overall unadjusted and adjusted analyses failed to show significant differences between genders in terms of major adverse cardiac and cerebrovascular events at a median follow-up of 13 months (range 8 to 18). At late follow-up (landmark analysis >12 months), a survival benefit was observed in women (hazard ratio 0.27, 95% confidence interval 0.09 to 0.84, p = 0.02). In conclusion, in this multicenter registry, the gender-based comparison of TAVI patients showed that men, despite the younger age, had more extensive atherosclerotic burden compared to women. Overall, the early and mid-term outcomes were similar between genders, although women might have a survival benefit with longer follow-up.

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