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Women have higher survival rates than men after transcatheter valve replacement

Women undergoing transcatheter aortic valve replacement (TAVR) have better survival rates than men at one year, according to a study published in Annals of Internal Medicine. These results are the opposite of those seen in surgical aortic valve replacement (SAVR), for which female sex has been shown to be associated with poorer outcomes.

TAVR has emerged as an alternative for patients with symptomatic aortic stenosis who have been deemed high-risk or inoperable for SAVR due to comorbidities or unfavorable anatomy. Female sex has been shown to be associated with increased risk for adverse events after SAVR, but data examining outcomes after TAVR have been conflicting. Researchers performed a secondary analysis of the Placement of Aortic Transcatheter Valves (PARTNER) Trial to compare postprocedural complications and one-year all-cause mortality among men and women who had TAVR. They found that women undergoing TAVR had a lower mortality rate at one year compared to men and also had a lower rate of rehospitalization. However, the women had a higher 30-day incidence of vascular complications and major bleeding.

Research: Sex-Specific Differences at Presentation and Outcomes Among Patients Undergoing Transcatheter Aortic Valve Replacement: A Cohort Study, Susheel Kodali, MD; Mathew R. Williams, MD; Darshan Doshi, MD, MS; Rebecca T. Hahn, MD; Karin H. Humphries, DSc; Vuyisile T. Nkomo, MD, MPH; David J. Cohen, MD, MSc; Pamela S. Douglas, MD; Michael Mack, MD; Ke Xu, PhD; Lars Svensson, MD, PhD; Vinod H. Thourani, MD; E. Murat Tuzcu, MD; Neil J. Weissman, MD; Martin Leon, MD; and Ajay J. Kirtane, MD, SM, Annals of Internal Medicine, doi:10.7326/M15-0121, published online 23 February 2016.

Editorial: Sex-Specific Research: A Key Component in Improving Prognosis After Transcatheter Aortic Valve Replacement, Nina Johnston, MD, PhD; and Christina Christersson, MD, PhD, Annals of Internal Medicine, doi:10.7326/M16-0105, published online 23 February 2016.