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

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

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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