Does Gender Influence the Indication of Treatment and Long-Term Prognosis in Severe Aortic Stenosis?
Introduction: It is a matter of controversy whether the therapeutic strategy for severe aortic stenosis (AS) differs according to gender. Methods: Retrospective study of patients diagnosed with severe AS (transvalvular mean gradient >= 40 mmHg and/or aortic valvular area < 1 cm(2)) between 2009 and...
| Autores: | ; ; ; ; ; ; ; ; ; ; ; ; |
|---|---|
| Tipo de documento: | Artículo |
| Estado: | Published version |
| Fecha de publicación: | 2023 |
| País: | España |
| Institución: | Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) |
| Repositorio: | r-FISABIO. Repositorio Institucional de Producción Científica |
| OAI Identifier: | oai:fisabio.fundanetsuite.com:p14845 |
| Acceso en línea: | https://fisabio.portalinvestigacion.com/publicaciones/14845 |
| Nivel de acceso: | Acceso abierto |
| Palabra clave: | aortic valve stenosis sex differences aortic valve replacement mortality treatment outcome |
| Sumario: | Introduction: It is a matter of controversy whether the therapeutic strategy for severe aortic stenosis (AS) differs according to gender. Methods: Retrospective study of patients diagnosed with severe AS (transvalvular mean gradient >= 40 mmHg and/or aortic valvular area < 1 cm(2)) between 2009 and 2019. Our aim was to assess the association of sex on AVR or medical management and outcomes in patients with severe AS. Results: 452 patients were included. Women (51.1%) were older than men (80 +/- 8.4 vs. 75.8 +/- 9.9 years; p < 0.001). Aortic valve replacement (AVR) was performed less frequently in women (43.4% vs. 53.2%; p = 0.03), but multivariate analyses showed that sex was not an independent predictor factor for AVR. Age, Charlson index and symptoms were predictive factors (OR 0.81 [0.82-0.89], OR 0.81 [0.71-0.93], OR 22.02 [6.77-71.64]). Survival analysis revealed no significant association of sex within all-cause and cardiovascular mortalities (log-rank p = 0.63 and p = 0.07). Cox proportional hazards analyses showed AVR (HR: 0.1 [0.06-0.15]), Charlson index (HR: 1.13 [1.06-1.21]) and reduced LVEF (HR: 1.9 [1.32-2.73]) to be independent cardiovascular mortality predictors. Conclusions: Gender is not associated with AVR or long-term prognosis. Cardiovascular mortality was associated with older age, more comorbidity and worse LVEF. |
|---|