Predictors of 1-year mortality after TAVR are significantly different among men and women
One-year mortality is more common among men undergoing transcatheter aortic valve replacement (TAVR) than women, according to new findings published in the American Journal of Cardiology.[1] The study’s authors also explored different factors that can help predict post-TAVR mortality in the two sexes.
“Although there is extensive evidence for predictors of post-TAVR adverse outcomes, there is a lack of information regarding risk factors in men and women specifically,” wrote lead author Samantha Novotny, BS, with the Renaissance School of Medicine at Stony Brook University in New York, and colleagues. “Because there are known gender-specific differences in aortic stenosis and TAVR outcomes, identifying predictors of adverse outcomes in men and women may prove useful for appropriate risk stratification.”
Novotny et al. explored data from nearly 300 TAVR patients who were treated at a single facility from December 2015 to June 2018. All patients underwent transfemoral TAVR, receiving a heart valve developed by Edwards Lifesciences or Medtronic. The authors noted that 51.5% of patients were men. The mean patient ages were 79 years old among the men and 81 years old among the women.
Overall, one-year mortality after the first year was 20.3% among men and 11.1% among women. Risk-adjusted mortality was also significantly higher among men than women. The group noted that predicting post-TAVR mortality could be challenging due to the fact that different factors appear to play a role for men and women.
“The delineation of disparate predictors of one-year mortality in men and women is important to consider for patient-specific risk stratification, allowing clinicians to better predict which patients may need closer follow-up,” the authors wrote.
Among men, chronic obstructive pulmonary disease (COPD), higher serum creatinine levels and lower body mass indexes were all associated with a heightened risk of one-year mortality. Among women, on the other hand, atrial fibrillation (AFib) and peripheral artery disease (PAD) were associated with a heightened risk of one-year mortality.
“Although AFib and PAD predicted one-year mortality in women, these pre-existing conditions are more common in men who underwent TAVR,” the authors added. “COPD, which was an independent risk factor for mortality in men in this study, has also been shown to be more frequent in men than women who underwent TAVR.”
The team did emphasize that there were certain limitations to consider. For example, it was a relatively small sample size taken from a single academic center. Also, follow-up imaging data was not available for each patient, which meant the authors could not explore echocardiogram results for additional information.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.