Lis Victória Ravani, Henrique Barbosa Ribeiro, Pedro Calomeni, Fábio Sandoli de Brito, Fernando Bernardi, Pedro Lemos, Fausto Feres, Dimytri Alexandre Siqueira, Ricardo Costa, Rogério Sarmento-Leite, Fernanda Mangione, José Armando Mangione, Luiz Eduardo Koenig São Thiago, Valter Correia de Lima, Adriano Dias Dourado Oliveira, Marcos Antônio Marino, Carlos José Francisco Cardoso, Paulo Ricardo Avancini Caramori, Rogério Tadeu Tumelero, Antenor Lages Fortes Portela, Maurício Lopes Prudente, Leônidas Alvarenga Henriques, Fabio Solano de Freitas Souza, Cristiano Guedes Bezerra, Guy Fernandes de Almeida Prado Junior, Leandro Zacarias Figueiredo de Freitas, Ederlon Ferreira Nogueira, George César Ximenes Meirelle, Renato Bastos Pope, Ênio Eduardo Guérios, Pedro Beraldo de Andrade, Luciano de Moura Santos, Mauricio Felippi de Sá Marchi, Vinicius Borges Cardozo Esteves, Alexandre Abizaid
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引用次数: 0
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is a well-established treatment for symptomatic patients with aortic stenosis. Yet, the impact of sex differences and public vs. private procedural setting on TAVI outcomes remain uncertain.
Methods: The RIBAC-NT (Brazilian Registry for Evaluation of Transcatheter Aortic Valve Replacement Outcomes) dataset included 3194 TAVI patients from 2009 to 2021. This retrospective analysis explored disparities in baseline characteristics, procedural and in-hospital outcomes stratifying patients by sex and procedural setting. Temporal trends were also investigated.
Results: We included 1551 (49 %) female and 1643 (51 %) male patients. Women were older (83 [78-87] vs. 81 [75-85] years; p < 0.01) but had a lower prevalence of diabetes mellitus (30.2 % vs. 36.3 %, p < 0.01) and coronary artery disease (39.0 % vs. 52.2 %, p < 0.01). However, women had a 3-fold higher higher risk of life-threatening bleeding (6.1 % vs. 2.4 %, p < 0.01). Women presented higher procedural and in-hospital mortality rates (4.4 % vs. 2.5 % and 7.7 % vs. 4.5 %, all p < 0.01, respectively). Although public hospitals presented ~2-fold higher procedural mortality rate compared with private settings (5.0 % vs. 2.7 %, p < 0.01), after multivariable analysis procedural setting was not independently associated with in-hospital mortality.
Conclusions: Women had higher procedural and in-hospital mortality rates after TAVI as compared with men, while facing higher life-threatening bleeding and adverse events rates. Although public hospitals exhibited higher mortality rates than private centers, procedural setting was not independently associated with in-hospital mortality.
期刊介绍:
Cardiovascular Revascularization Medicine (CRM) is an international and multidisciplinary journal that publishes original laboratory and clinical investigations related to revascularization therapies in cardiovascular medicine. Cardiovascular Revascularization Medicine publishes articles related to preclinical work and molecular interventions, including angiogenesis, cell therapy, pharmacological interventions, restenosis management, and prevention, including experiments conducted in human subjects, in laboratory animals, and in vitro. Specific areas of interest include percutaneous angioplasty in coronary and peripheral arteries, intervention in structural heart disease, cardiovascular surgery, etc.