Sex-specific aspects on prognosis after aortic valve replacement for aortic stenosis: a SWEDEHEART registry study.
Open Heart
; 11(2)2024 Jul 23.
Article
de En
| MEDLINE
| ID: mdl-39043607
ABSTRACT
OBJECTIVE:
To compare long-term cardiovascular (CV) outcomes between men and women with aortic stenosis (AS) undergoing aortic valve replacement (AVR) by the type of valve implant.METHODS:
The study population consisted of 14 123 non-selected patients with AS undergoing first-time AVR and included in the Swedish Web system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) registry during 2008-2016. Comparisons were made between men and women and type of valve implant (ie, surgical implantation with a mechanical (mSAVR) (n=1 966) or biological valve (bioSAVR) (n=9 801)) or by a transcatheter approach (TAVR) (n=2 356). Outcomes included all-cause mortality, ischaemic stroke, major bleeding, thromboembolic events, heart failure and myocardial infarction, continuously adjusted for significant comorbidities and medical treatment.RESULTS:
In the mSAVR cohort, there were no significant sex differences in any CV events. In the bioSAVR cohort, a higher risk of death (HR 1.14; 95% CI 1.04 to 1.26, p=0.007) and major bleeding (HR 1.41; 95% CI 1.18 to 1.69, p<0.001) was observed in men. In the TAVR cohort, men suffered a higher risk of death (HR 1.24; 95% CI 1.07 to 1.45, p=0.005), major bleeding (HR 1.35; 95% CI 1.00 to 1.82, p=0.022) and thromboembolism (HR 1.35, 95% CI 1.00 to 1.82, p=0.047).CONCLUSION:
No significant long-term difference in CV events was noted between men and women undergoing AVR with a mechanical aortic valve. In both the bioSAVR and TAVR cohort, mortality was higher in men who also had an increased incidence of several other CV events.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Valve aortique
/
Sténose aortique
/
Enregistrements
/
Implantation de valve prothétique cardiaque
Limites:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Pays/Région comme sujet:
Europa
Langue:
En
Journal:
Open Heart
/
Open heart (Online)
Année:
2024
Type de document:
Article
Pays d'affiliation:
Suède
Pays de publication:
Royaume-Uni