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Four‐year mortality in women and men after transfemoral transcatheter aortic valve implantation using the SAPIEN 3
Author(s) -
Tarantini Giuseppe,
Baumgartner Helmut,
Frank Derk,
Husser Oliver,
Bleiziffer Sabine,
Rudolph Tanja,
Jeger Raban,
Fraccaro Chiara,
Hovorka Tomas,
Wendler Olaf
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.29257
Subject(s) - medicine , hazard ratio , cohort , proportional hazards model , cardiology , stenosis , cohort study , surgery , confidence interval
Objectives To investigate 4‐year, post‐transcatheter aortic valve implantation (TAVI) survival and predictors of survival by sex, in a real‐world cohort that underwent transfemoral TAVI with SAPIEN 3 transcatheter heart valve. Background Previous TAVI investigations of first‐generation devices demonstrated an early‐ to mid‐term survival advantage in women compared with men. Methods SOURCE 3 (SAPIEN 3 Aortic Bioprosthesis European Outcome) is a post‐approval, multicentre, observational registry. Patients ( N = 1,694, 49.2% women, age 81.7 ± 6.7 years) with severe aortic stenosis and high surgical risk (logistic EuroSCORE 17.8%) underwent TAVI between 2014 and 2015. Kaplan–Meier event estimates were used to determine mortality by sex. Predictors of overall mortality were identified using a cox multivariate proportional hazard model. Results At 4 years, women had lower all‐cause mortality than men (36.0 vs 39.7%; p = .0911; HR: 0.87 [95% CI: 0.75–1.02]). No difference was observed for cardiac mortality between women 24.2% and men 24.7% ( p = .76; HR: 0.97 [95% CI: 0.79–1.19]). When adjusted for baseline characteristics (age, height, weight, NYHA functional class, renal insufficiency, EuroScore, and tricuspid regurgitation), sex had no impact on mortality. Conclusions In this large, real‐world cohort, all‐cause mortality trended lower in women than men at 4 years post TAVI; however, several baseline factors, but not sex, were predictors of mortality. No difference between sexes was observed for cardiovascular mortality.