TY - JOUR T1 - IMPULSE: the impact of gender on the presentation and management of aortic stenosis across Europe JF - Open Heart JO - Open Heart DO - 10.1136/openhrt-2020-001443 VL - 8 IS - 1 SP - e001443 AU - Richard Paul Steeds AU - David Messika-Zeitoun AU - Jeetendra Thambyrajah AU - Antonio Serra AU - Eberhard Schulz AU - Jiri Maly AU - Marco Aiello AU - Tanja K Rudolph AU - Guy Lloyd AU - Alessandro Santo Bortone AU - Alberto Clerici AU - Georg Delle-Karth AU - Johannes Rieber AU - Ciro Indolfi AU - Massimo Mancone AU - Loic Belle AU - Alexander Lauten AU - Martin Arnold AU - Berto J Bouma AU - Matthias Lutz AU - Cornelia Deutsch AU - Jana Kurucova AU - Martin Thoenes AU - Peter Bramlage AU - Norbert Frey A2 - , Y1 - 2021/01/01 UR - http://openheart.bmj.com/content/8/1/e001443.abstract N2 - 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. ER -