PT  - JOURNAL ARTICLE
AU  - Paul T L Chiam
AU  - Kentaro Hayashida
AU  - Yusuke Watanabe
AU  - Wei-Hsian Yin
AU  - Hsien-Li Kao
AU  - Michael K Y Lee
AU  - Fabio Enrique Posas
AU  - Mann Chandavimol
AU  - Wacin Buddhari
AU  - Timothy C Dy
AU  - Ngoc Quang Nguyen
AU  - Won Jang Kim
AU  - Kiyuk Chang
AU  - Mao-Shin Lin
AU  - Yat-Yin Lam
AU  - Hung Manh Pham
AU  - Shaiful Azmi Yahaya
AU  - Kay Woon Ho
AU  - Wenzhi Pan
AU  - Xian-bao Liu
AU  - Jian'an Wang
AU  - Hyo Soo Kim
AU  - Mao Chen
TI  - Sex differences in patients undergoing transcatheter aortic valve replacement in Asia
AID  - 10.1136/openhrt-2020-001541
DP  - 2021 Jan 01
TA  - Open Heart
PG  - e001541
VI  - 8
IP  - 1
4099  - http://openheart.bmj.com/content/8/1/e001541.short
4100  - http://openheart.bmj.com/content/8/1/e001541.full
SO  - Open Heart2021 Jan 01; 8
AB  - Objectives Transcatheter aortic valve replacement (TAVR) is increasingly performed. Physically small Asians have smaller aortic root and peripheral vessel anatomy. The influence of gender of Asian patients undergoing TAVR is unknown and may affect outcomes. The aim of this study was to assess sex differences in Asian patients undergoing TAVR.Methods Patients undergoing TAVR from eight countries were enrolled. In this retrospective analysis, we examined differences in characteristics, 30-day clinical outcomes and 1-year survival between female and male Asian patients.Results Eight hundred and seventy-three patients (54.4% women) were included. Women were older, smaller and had less coronary artery and lung disease but tended to have higher logistic EuroSCOREs. Smaller prostheses were used more often in women. Major vascular complications occurred more frequently in women (5.5% vs 1.8%, p<0.01); however, 30-day stroke and mortality (women vs men: 1.5% vs 1.6%, p=0.95% and 4.3% vs 3.4%, p=0.48) were similar. Functional status improvement was significant and comparable between the sexes. Conduction disturbance and permanent pacemaker requirements (11.2% vs 9.0%, p=0.52) were also similar as was 1-year survival (women vs men: 85.6% vs 88.2%, p=0.25). The only predictors of 30-day mortality were major vascular injury in women and age in men.Conclusions Asian women had significantly smaller stature and anatomy with some differences in clinical profiles. Despite more frequent major vascular complications, women had similar 30-day stroke or mortality rates. Functional status improvement was significant and comparable between the sexes. Conduction disturbance and permanent pacemaker requirements were similar as was 1-year survival.