Published in:
Catheterization and Cardiovascular Interventions, 97 (2021) 5, Seite 876-884
Language:
English
DOI:
10.1002/ccd.29257
ISSN:
1522-1946;
1522-726X
Origination:
Footnote:
Description:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Objectives</jats:title><jats:p>To investigate 4‐year, post‐transcatheter aortic valve implantation (TAVI) survival and predictors of survival by sex, in a real‐world cohort that underwent transfemoral TAVI with SAPIEN 3 transcatheter heart valve.</jats:p></jats:sec><jats:sec><jats:title>Background</jats:title><jats:p>Previous TAVI investigations of first‐generation devices demonstrated an early‐ to mid‐term survival advantage in women compared with men.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>SOURCE 3 (SAPIEN 3 Aortic Bioprosthesis European Outcome) is a post‐approval, multicentre, observational registry. Patients (<jats:italic>N</jats:italic> = 1,694, 49.2% women, age 81.7 ± 6.7 years) with severe aortic stenosis and high surgical risk (logistic EuroSCORE 17.8%) underwent TAVI between 2014 and 2015. Kaplan–Meier event estimates were used to determine mortality by sex. Predictors of overall mortality were identified using a cox multivariate proportional hazard model.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>At 4 years, women had lower all‐cause mortality than men (36.0 vs 39.7%; <jats:italic>p</jats:italic> = .0911; HR: 0.87 [95% CI: 0.75–1.02]). No difference was observed for cardiac mortality between women 24.2% and men 24.7% (<jats:italic>p</jats:italic> = .76; HR: 0.97 [95% CI: 0.79–1.19]). When adjusted for baseline characteristics (age, height, weight, NYHA functional class, renal insufficiency, EuroScore, and tricuspid regurgitation), sex had no impact on mortality.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>In this large, real‐world cohort, all‐cause mortality trended lower in women than men at 4 years post TAVI; however, several baseline factors, but not sex, were predictors of mortality. No difference between sexes was observed for cardiovascular mortality.</jats:p></jats:sec>