Study: Women Are More Likely to Survive TAVR Than Men

According to a new study, women have a better survival rate then men 1 year after a transcatheter aortic valve replacement surgery, despite associations for higher risks and complications occurring in the hospital.

Researchers used data from the Society of Thoracic Surgeons and American College of Cardiology Transcatheter Valve Therapy Registry to assess in-hospital outcomes for men and women. Data from the Centers for Medicare and Medicaid Services were used for assessing outcomes after 1 year. They collected information on 11,808 women and 11,844 men between 2011 to 2014 who had transcatheter aortic valve replacement surgery.
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Their findings showed that women were older than men, but had a lower prevalence of coronary artery disease, atrial fibrillation, and diabetes. However, women did have a higher rate of porcelain aorta, and lower glomerular filtration. Likewise, women had a higher prevalence of in-hospital complications (8.27%) compared to men (4.39%), and higher bleeding rates (8.01%) compared to men (5.96%). Women and men had similar survival rates immediately after being discharged. After 1 year, the mortality rate of women was 21.3% and the mortality rate of men was 24.5%.

Overall, the researchers found that women have a higher rate of survival 1 year after transcatheter aortic valve replacement surgery compared to men, even though they have a higher risk for in-hospital complications.

Researchers noticed that the higher rate of women receiving early remodeling and left ventricular regression after transcatheter aortic valve replacement surgery decreases rehospitalization and may increase the survival rate in women. “Moreover, vascular complications have recently been shown to have a much lower impact on 30-day mortality than bleeding, suggesting that vascular complications may be amenable to prompt and successful management in the majority. This scenario may provide an explanation for the higher 1-year survival in female patients despite greater vascular complications,” Researchers stated.

Further research is need on the medium and long term causes of death in patients who received transcatheter aortic valve replacement surgery to assess the disparity between men and women, and to better address risks in patients undergoing the surgery.

—Melissa Weiss

Reference:

Chandrasekhar J, Dangas G, Yu J, et al. Sex-based differences in outcomes with transcatheter aortic valve therapy: TVT Registry from 2011 to 2014 [published online December 19, 2016]. Journal of the American College of Caridology. doi: 10.1016/j.jacc.2016.10.041.