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首页> 外文期刊>The American Journal of Cardiology >Impact of Gender on Transcatheter Aortic Valve Implantation Outcomes
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Impact of Gender on Transcatheter Aortic Valve Implantation Outcomes

机译：性别对经转沟管主动脉瓣植入结果的影响

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Previous studies indicate that women who underwentwho underwent transcatheter aortic valve implantation (TAVI) have poorer 30-day outcomes compared with men. However, the effect of gender as a prognostic factor for long-term outcomes following TAVI remains unclear. Between 2008 and 2018, all patients (n = 683) who underwent TAVI in 2 centres in Melbourne, Australia were prospectively included in a registry. The primary end-point was long-term mortality. The secondary end points were Valve Academic Research Consortium-2 (VARC-2) in-hospital complications and mortality at 30-days and 1-year. Of 683 patients, 328 (48%) were women. Women had a higher mean STS-PROM score (5.2 +/- 3.1 vs 4.6 +/- 3.5, p < 0.001) but less co-morbidities than men. Women had a significantly higher in-hospital bleeding rates (3.3% vs 1.0%, Odds Ratio 4.21, 95% confidence interval [CI] 1.16 to15.25, p = 0.027) and higher 30-day mortality (2.4% vs 0.3%, hazard ratio [HR] 8.75, 95% CI 1.09 to 69.6, p = 0.040) than men. Other VARC-2 outcomes were similar between genders. Overall mortality rate was 36% (246) over a median follow up of 2.7 (interquartile rang [IQR] 1.7 to 4.2) years. Median time to death was 5.3 (95% CI 4.7 to 5.7) years. One-year mortality was similar between genders (8.3% vs 7.8%), as was longterm mortality (HR = 0.91, 95% CI 0.71 to 1.17, p = 0.38). On multivariable analysis, female gender was an independent predictor for 1-year mortality (HR = 2.33, 95% CI 1.11 to 4.92, p = 0.026), but not long-term mortality (HR = 0.78, 95% CI 0.54 to 1.14, p = 0.20). In the women only cohort, STS-PROM was the only independent predictor of long-term mortality (HR 1.88, 95% CI 1.42 to 2.48, p < 0.001). In conclusion, women had higher rates of peri-procedural major bleeding and 30-day mortality following TAVI. However, long-term outcomes were similar between genders. (c) 2020 Elsevier Inc. All rights reserved.
机译：之前的研究表明，与男性相比，接受经导管主动脉瓣植入术（TAVI）的女性在30天内的预后较差。然而，性别作为TAVI后长期预后因素的影响尚不清楚。2008年至2018年期间，在澳大利亚墨尔本的两个中心接受TAVI治疗的所有患者（n=683）均被前瞻性纳入登记册。主要终点是长期死亡率。次要终点是Valve Academic Research Consortium-2（VARC-2）30天和1年的住院并发症和死亡率。683名患者中，328名（48%）为女性。女性的STS-PROM平均得分较高（5.2+/-3.1 vs 4.6+/-3.5，p<0.001），但合并症较男性少。女性住院出血率（3.3%比1.0%，优势比4.21，95%可信区间[CI]1.16到15.25，p=0.027）和30天死亡率（2.4%比0.3%，危险比[HR]8.75，95%可信区间1.09到69.6，p=0.040）明显高于男性。其他VARC-2结果在性别之间相似。中位随访2.7年（四分位间距[IQR]1.7至4.2年），总死亡率为36%（246）。中位死亡时间为5.3年（95%可信区间为4.7至5.7）。男女之间的一年死亡率相似（8.3%对7.8%），长期死亡率也相似（HR=0.91，95%可信区间0.71-1.17，p=0.38）。在多变量分析中，女性是1年死亡率的独立预测因子（HR=2.33，95%可信区间1.11至4.92，p=0.026），但不是长期死亡率（HR=0.78，95%可信区间0.54至1.14，p=0.20）。在仅限女性的队列中，STS-PROM是长期死亡率的唯一独立预测因子（HR1.88，95%可信区间1.42至2.48，p<0.001）。总之，女性TAVI术后围手术期大出血率和30天死亡率较高。然而，性别之间的长期结果相似。（c） 2020爱思唯尔公司版权所有。

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