经导管主动脉瓣植入术后性别对院内和长期预后的影响:西班牙 TAVI 登记分析。

IF 7.2 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Revista española de cardiología (English ed.) Pub Date : 2024-08-24 DOI:10.1016/j.rec.2024.08.002
Rami Gabani, Salvatore Brugaletta, Kamil Bujak, María José Pèrez-Vizcayno, Pilar Jiménez-Quevedo, Víctor Arévalos, Erika Muñoz-García, Ramiro Trillo-Nouche, Raquel Del Valle, José M de la Torre Hernández, Luisa Salido, Enrique Gutiérrez, Manuel Pan, Joaquín Sánchez-Gila, Bruno García Del Blanco, Raúl Moreno, Roberto Blanco Mata, Juan Francisco Oteo, Ignacio Amat-Santos, Ander Regueiro, Francisco Ten, Juan Manuel Nogales, Eduard Fernández-Nofrerías, Leire Andraka, María Cruz Ferrer, Eduardo Pinar, Rafael Romaguera, Carlos Cuellas Ramón, Fernando Alfonso, Sergio García-Blas, Antonio Piñero, Julia Ignasi, Rocío Díaz Mèndez, Pascual Bordes, Juan Meseguer, Luis Nombela-Franco, Manel Sabaté
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引用次数: 0

摘要

导言和目的:性别对经导管主动脉瓣植入术(TAVI)后长期预后的影响仍不确定。我们旨在研究 TAVI 的性别差异及其对预后的影响:这项分析使用了西班牙前瞻性 TAVI 登记处的数据,其中包括 2009 年至 2021 年期间在 46 个西班牙中心接受治疗的连续 TAVI 患者。主要终点是12个月的全因死亡率。次要终点包括院内死亡率、30 天死亡率和 TAVI 相关并发症。进行了调整后的Logistic和Cox回归分析:研究纳入了12 253例连续的TAVI患者,平均年龄为(81.2 ± 6.4)岁。女性(53.9%)年龄较大,STS-PROM评分(7.0 ± 7.0 vs 6.2 ± 6.7;P < .001)高于男性。总体而言,女性和男性的 TAVI 相关并发症发生率相似,但也存在与性别相关的特殊并发症。女性更常出现院内血管并发症(13.6% vs 9.8%;P 结论:接受TAVI治疗的女性比男性年龄更大,合并症更多,导致了不同性别间并发症的差异。不过,男性和女性的短期和1年全因死亡率相似。
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Impact of gender on in-hospital and long-term outcomes after transcatheter aortic valve implantation: an analysis of the Spanish TAVI registry.

Introduction and objectives: Impact of gender on long-term outcomes after transcatheter aortic valve implantation (TAVI) remains uncertain. We aimed to investigate gender-specific differences in TAVI and its impact on outcomes.

Methods: This analysis used data from the prospective Spanish TAVI registry, which included consecutive TAVI patients treated in 46 Spanish centers from 2009 to 2021. The primary endpoint was all-cause mortality at 12 months. Secondary endpoints included in-hospital and 30-day mortality and TAVI-related complications. Adjusted logistic and Cox regression analyses were performed.

Results: The study included 12 253 consecutive TAVI patients with a mean age of 81.2±6.4 years. Women (53.9%) were older, and had a higher STS-PROM score (7.0±7.0 vs 6.2±6.7; P < .001) than men. Overall, the TAVI-related complication rate was similar between women and men, with specific gender-related complications. While women more frequently developed in-hospital vascular complications (13.6% vs 9.8%; P <.001) and cardiac tamponade (1.5% vs 0.6%; P=.009), men showed a higher incidence of permanent pacemaker implantation (14.5% vs 17.4%; P=.009). There was no difference in all-cause mortality either in hospital (3.6% vs 3.6%, adjusted OR, 1.01; 95%CI, 0.83-1.23; P=.902), at 30 days (4.2% vs 4.2%, adjusted OR, 0.90; 95%CI, 0.65-1.25; P=.564) or at 1 year (11% vs 13%, adjusted HR, 0.94; 95%CI, 0.80-1.11; P=.60).

Conclusions: Women treated with TAVI are older and have more comorbidities than men, leading to distinct complications between genders. Nevertheless, all-cause mortality in the short-term and at 1-year was similar between men and women.

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