Sex-Related Differences in Outcomes After Transcatheter Aortic Valve Implantation

Circulation: Cardiovascular Interventions - Tập 6 Số 5 - Trang 543-551 - 2013
Zhen‐Gang Zhao1, Yanbiao Liao2, Yong Peng3, Hua Chai4, Wei Liu5, Qiao Li6, Xin Ren7, Xueqin Wang8, Xiaolin Luo9, Chen Zhang10, Lihui Lu11, Qingtao Meng12, Chi Chen13, Mao Chen14, Yuan Feng15, Dejia Huang16
1Zhen-Gang Zhao From the Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.
2Yan-Biao Liao From the Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.
3Yong Peng From the Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.
4Hua Chai From the Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.
5Wei Liu From the Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.
6Qiao Li From the Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.
7Xin Ren From the Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.
8Xue-Qin Wang From the Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.
9Xiao-Lin Luo From the Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.
10Chen Zhang From the Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.
11Li-Hui Lu From the Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.
12Qing-Tao Meng From the Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.
13Chi Chen From the Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.
14Mao Chen From the Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.
15Yuan Feng From the Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.
16De-Jia Huang From the Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China.

Tóm tắt

Background— There were considerable discrepancies with regard to sex-related differences in complications and prognosis after transcatheter aortic valve implantation. Methods and Results— The Cochrane library and PubMed online databases were searched. Articles reporting sex-specific post–transcatheter aortic valve implantation complications and mortality were identified. Two authors selected studies and extracted data independently. Random- and fixed-effects models were used depending on between-study heterogeneity. There were 27 articles, a total of 9118 patients, enrolled in our systematic review and meta-analysis, including 4176 men and 4942 women. Pooled analyses suggested considerable sex-related differences in complications and early as well as midterm outcomes after transcatheter aortic valve implantation. The difference in the risk for heart block requiring permanent pacemaker implantation was noted to be significant only in the subgroup of the CoreValve-dominating studies (pooled risk ratio [RR, men versus women], 1.29; 95% confidence interval [CI], 1.13–1.47). Although men had significantly lower risks for major/life-threatening bleeding (pooled RR, 0.81; 95% CI, 0.68–0.96) and major vascular complications (pooled RR, 0.49; 95% CI, 0.37–0.66), they had poorer prognosis. In fact, male sex was associated with significantly higher risks for deaths at both 30 days (RR, 1.37; 95% CI, 1.07–1.76) and 1 year (RR, 1.30; 95% CI, 1.14–1.49). Conclusions— Although men had lower risks for major/life-threatening bleeding and major vascular complications after transcatheter aortic valve implantation, they had less favorable short-term and midterm survival.

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Circulation: Cardiovascular Interventions

Tập 6 Số 5

543-551

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