RT Journal Article
SR Electronic
T1 Sex-specific aspects on prognosis after aortic valve replacement for aortic stenosis: a SWEDEHEART registry study
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e002725
DO 10.1136/openhrt-2024-002725
VO 11
IS 2
A1 Johnston, Nina
A1 James, Stefan K
A1 Lindhagen, Lars
A1 Ståhle, Elisabeth
A1 Christersson, Christina
YR 2024
UL http://openheart.bmj.com/content/11/2/e002725.abstract
AB Objective To compare long-term cardiovascular (CV) outcomes between men and women with aortic stenosis (AS) undergoing aortic valve replacement (AVR) by the type of valve implant.Methods The study population consisted of 14 123 non-selected patients with AS undergoing first-time AVR and included in the Swedish Web system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) registry during 2008–2016. Comparisons were made between men and women and type of valve implant (ie, surgical implantation with a mechanical (mSAVR) (n=1 966) or biological valve (bioSAVR) (n=9 801)) or by a transcatheter approach (TAVR) (n=2 356). Outcomes included all-cause mortality, ischaemic stroke, major bleeding, thromboembolic events, heart failure and myocardial infarction, continuously adjusted for significant comorbidities and medical treatment.Results In the mSAVR cohort, there were no significant sex differences in any CV events. In the bioSAVR cohort, a higher risk of death (HR: 1.14; 95% CI: 1.04 to 1.26, p=0.007) and major bleeding (HR: 1.41; 95% CI: 1.18 to 1.69, p<0.001) was observed in men. In the TAVR cohort, men suffered a higher risk of death (HR: 1.24; 95% CI: 1.07 to 1.45, p=0.005), major bleeding (HR: 1.35; 95% CI: 1.00 to 1.82, p=0.022) and thromboembolism (HR: 1.35, 95% CI: 1.00 to 1.82, p=0.047).Conclusion No significant long-term difference in CV events was noted between men and women undergoing AVR with a mechanical aortic valve. In both the bioSAVR and TAVR cohort, mortality was higher in men who also had an increased incidence of several other CV events.Data are available upon reasonable request. SWEDEHEART does not allow individual data sharing to third parties. Access to aggregated data might be granted following review by the SWEDEHEART steering committee. Such requests can be submitted to the SWEDEHEART steering committee for consideration. For contact details see https://www.ucr.uu.se/swedeheart/kontakt/support.