Sex-related differences among patients undergoing surgical aortic valve replacement—a propensity score matched study

Zierer A, De Paulis R, Bakhtiary F, Ahmad AES, Andreas M, Autschbach R, Benedikt P, Binder K, Bonaros N, Borger M, Bourguignon T, Canovas S, Coscioni E, Dagenais F, Demers P, Dewald O, Feyrer R, Geißler HJ, Grabenwöger M, Grünenfelder J, Kueri S, Lam KY, Langanay T, Laufer G, Van Leeuwen W, Leyh R, Liebold A, Mariscalco G, Massoudy P, Mehdiani A, Pessotto R, Pollari F, Polvani G, Ricci A, Roussel JC, Salamate S, Siepe M, Stefano P, Strauch J, Theron A, Vötsch A, Weber A, Wendler O, Thielmann M, Eden M, Botta B, Bramlage P, Meuris B (2024)

Publication Type: Journal article

Publication year: 2024

Journal

Book Volume: 39

Article Number: ivae140

Journal Issue: 2

DOI: 10.1093/icvts/ivae140

Abstract

OBJECTIVES: We investigated the sex-related difference in characteristics and 2-year outcomes after surgical aortic valve replacement (SAVR) by propensity-score matching (PSM). METHODS: Data from 2 prospective registries, the INSPIRIS RESILIA Durability Registry (INDURE) and IMPACT, were merged, resulting in a total of 933 patients: 735 males and 253 females undergoing first-time SAVR. The PSM was performed to assess the impact of sex on the SAVR outcomes, yielding 433 males and 243 females with comparable baseline characteristics. RESULTS: Females had a lower body mass index (median 27.1 vs 28.0 kg/m²; P ¼ 0.008), fewer bicuspid valves (52% vs 59%; P ¼ 0.036), higher EuroSCORE II (mean 2.3 vs 1.8%; P < 0.001) and Society of Thoracic Surgeons score (mean 1.6 vs 0.9%; P < 0.001), were more often in New York Heart Association functional class III/IV (47% vs 30%; P < 0.001) and angina Canadian Cardiovascular Society III/IV (8.2% vs 4.4%; P < 0.001), but had a lower rate of myocardial infarction (1.9% vs 5.2%; P ¼ 0.028) compared to males. These differences vanished after PSM, except for the EuroSCORE II and Society of Thoracic Surgeons scores, which were still significantly higher in females. Furthermore, females required smaller valves (median diameter 23.0 vs 25.0 mm, P < 0.001). There were no differences in the length of hospital stay (median 8 days) or intensive care unit stay (median 24 vs 25 hours) between the 2 sexes. At 2 years, post-SAVR outcomes were comparable between males and females, even after PSM. CONCLUSIONS: Despite females presenting with a significantly higher surgical risk profile, 2-year outcomes following SAVR were comparable between males and females.

Authors with CRIS profile

Involved external institutions

Hospital Clínico Universitario Virgen de la Arrixaca Spain (ES) Centro Cardiologico Monzino (IRCCS) Italy (IT) Nantes University Hospital / Centre hospitalier universitaire de Nantes (CHU) France (FR) Universitätsklinikum Bonn Germany (DE) Universitäts-Herzzentrum Freiburg - Bad Krozingen GmbH Germany (DE) Catharina Hospital / Catharina Ziekenhuis Netherlands (NL) Centre hospitalier universitaire de Rennes / CHU Rennes France (FR) Medizinische Universität Wien Austria (AT) Erasmus University Medical Center (MC) Netherlands (NL) Herzzentrum Leipzig Germany (DE) François Rabelais University Tours France (FR) Ospedali Riuniti San Giovanni di Dio e Ruggi d'Aragona Italy (IT) CHU de Québec-Université Laval Canada (CA) Institut de Cardiologie de Montréal Canada (CA) Kepler Universitätsklinikum (KUK) Austria (AT) Julius-Maximilians-Universität Würzburg Germany (DE) Universitätsklinikum Ulm Germany (DE) Glenfield Hospital United Kingdom (GB) Klinikum Passau Germany (DE) Universitätsklinikum Düsseldorf Germany (DE) Royal Infirmary of Edinburgh NHS Trust United Kingdom (GB) Klinikum Nürnberg Germany (DE) IPPMed - Institut für Pharmakologie und Präventive Medizin GmbH Germany (DE) University Hospital Leuven (UZ) / Universitaire ziekenhuizen Leuven Belgium (BE) Universitätsklinikum Aachen (UKA) Germany (DE) Universitätsklinikum St. Pölten Austria (AT) Medizinische Universität Innsbruck Austria (AT) Wiener Gesundheitsverbund Kliniken Austria (AT) Hirslanden AG / Privatklinikgruppe Hirslanden Switzerland (CH) Paracelsus Medizinische Privatuniversität Austria (AT) HerzZentrum Hirslanden Zurich Switzerland (CH) King's College Hospital (KCH) United Kingdom (GB) Universitätsklinikum Essen Germany (DE) Ruprecht-Karls-Universität Heidelberg Germany (DE) Careggi University Hospital / Azienda Ospedaliero Universitaria Careggi Italy (IT) Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil Germany (DE) Hôpital de la Timone France (FR)

How to cite

APA:

Zierer, A., De Paulis, R., Bakhtiary, F., Ahmad, A.E.S., Andreas, M., Autschbach, R.,... Meuris, B. (2024). Sex-related differences among patients undergoing surgical aortic valve replacement—a propensity score matched study. Interdisciplinary CardioVascular and Thoracic Surgery, 39(2). https://doi.org/10.1093/icvts/ivae140

MLA:

Zierer, Andreas, et al. "Sex-related differences among patients undergoing surgical aortic valve replacement—a propensity score matched study." Interdisciplinary CardioVascular and Thoracic Surgery 39.2 (2024).

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