RT Journal Article SR Electronic T1 IMPULSE: the impact of gender on the presentation and management of aortic stenosis across Europe JF Open Heart JO Open Heart FD British Cardiovascular Society SP e001443 DO 10.1136/openhrt-2020-001443 VO 8 IS 1 A1 Richard Paul Steeds A1 David Messika-Zeitoun A1 Jeetendra Thambyrajah A1 Antonio Serra A1 Eberhard Schulz A1 Jiri Maly A1 Marco Aiello A1 Tanja K Rudolph A1 Guy Lloyd A1 Alessandro Santo Bortone A1 Alberto Clerici A1 Georg Delle-Karth A1 Johannes Rieber A1 Ciro Indolfi A1 Massimo Mancone A1 Loic Belle A1 Alexander Lauten A1 Martin Arnold A1 Berto J Bouma A1 Matthias Lutz A1 Cornelia Deutsch A1 Jana Kurucova A1 Martin Thoenes A1 Peter Bramlage A1 Norbert Frey A1 , YR 2021 UL http://openheart.bmj.com/content/8/1/e001443.abstract AB 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.