IMPULSE : The impact of gender on the presentation and management of aortic stenosis across Europe
Steeds, Richard (Queen Elizabeth Hospital and Institute of Cardiovascular Sciences. University of Birmingham)
Messika-Zeitoun, David (University of Ottawa Heart Institute)
Thambyrajah, Jeetendra (James Cook University Hospital)
Serra, Antonio (Institut d'Investigació Biomèdica Sant Pau)
Schulz, Eberhard (Cardiology Department. AKH Celle)
Maly, Jiri (Department of Cardiovascular Surgery. Second Faculty of Medicine. Charles University)
Aiello, Marco (Department of Cardiothoracic Surgery. Foundation IRCCS Policlinico S.Matteo)
Rudolph, Tanja K. (Department of Cardiology. Heart and Diabetes Center Bad Oeynhausen. Ruhr-University of Bochum)
Lloyd, Guy (St Bartholomew's Hospital)
Bortone, Alessandro Santo (University of Bari)
Clerici, Alberto (University of Turin)
Delle-Karth, Georg (4th Medical Department. Hietzing Hospital)
Rieber, Johannes (Herzkatheterlabor Nymphenburg and Department of Cardiology. University of Munich)
Indolfi, Ciro (Division of Cardiology and URT CNR of IFC. University Magna Graecia)
Mancone, Massimo (Sapienza University of Rome)
Belle, Loic (Centre Hospital d'Annecy)
Lauten, Alexander (Department for Cardiology. Helios Erfurt Clinic)
Arnold, Martin (Department of Cardiology. University of Erlangen)
Bouma, Berto J. (University of Amsterdam)
Lutz, Matthias (University of Kiel. Department of Cardiology and Angiology)
Deutsch, Cornelia (Institute for Pharmacology and Preventive Medicine)
Kurucova, Jana (Edwards Lifesciences)
Thoenes, Martin (Edwards Lifesciences)
Bramlage, Peter (Institute for Pharmacology and Preventive Medicine)
Frey, Norbert (Department of Cardiology and Angiology. University of Kiel)

Date:	2021
Abstract:	Aims There is an increasing awareness of gender-related differences in patients with severe aortic stenosis and their outcomes after surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI). Methods Data from the IMPULSE registry were analysed. Patients with severe aortic stenosis (AS) were enrolled between March 2015 and April 2017 and stratified by gender. A subgroup analysis was performed to assess the impact of age. Results Overall, 2171 patients were enrolled, and 48. 0% were female. Women were characterised by a higher rate of renal impairment (31. 7 vs 23. 3%; p<0. 001), were at higher surgical risk (EuroSCORE II: 4. 5 vs 3. 6%; p=0. 001) and more often in a critical preoperative state (7. 0vs 4. 2%; p=0. 003). Men had an increased rate of previous cardiac surgery (9. 4 vs 4. 7%; p<0. 001) and a reduced left ventricular ejection fraction (4. 9 vs 1. 3%; p<0. 001). Concomitant mitral and tricuspid valve disease was substantially more common among women. Symptoms were highly prevalent in both women and men (83. 6 vs 77. 3%; p<0. 001). AVR was planned in 1379 cases. Women were more frequently scheduled to undergo TAVI (49. 3 vs 41. 0%; p<0. 001) and less frequently for SAVR (20. 3 vs 27. 5%; p<0. 001). Conclusions The present data show that female patients with severe AS have a distinct patient profile and are managed in a different way to males. Gender-based differences in the management of patients with severe AS need to be taken into account more systematically to improve outcomes, especially for women.
Note:	Altres ajuts: Edwards Lifesciences (Nyon, Switzerland).
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Open Heart, Vol. 8 Núm. 1 (august 2021) , p. e001443, ISSN 2053-3624

DOI: 10.1136/openhrt-2020-001443
PMID: 33419934

9 p, 874.8 KB

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