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Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis

Previous studies have demonstrated gender disparities in mortality and vascular complications after transcatheter aortic valve replacement (TAVR) with early generation transcatheter heart valves (THVs). It is unclear, however, whether gender-related differences persist with the newer generation THVs...

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Autores principales: Trongtorsak, Angkawipa, Thangjui, Sittinun, Adhikari, Pabitra, Shrestha, Biraj, Kewcharoen, Jakrin, Navaravong, Leenhapong, Kanjanauthai, Somsupha, Attanasio, Steve, Saudye, Hammad A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204443/
https://www.ncbi.nlm.nih.gov/pubmed/37218985
http://dx.doi.org/10.3390/medsci11020033
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author Trongtorsak, Angkawipa
Thangjui, Sittinun
Adhikari, Pabitra
Shrestha, Biraj
Kewcharoen, Jakrin
Navaravong, Leenhapong
Kanjanauthai, Somsupha
Attanasio, Steve
Saudye, Hammad A.
author_facet Trongtorsak, Angkawipa
Thangjui, Sittinun
Adhikari, Pabitra
Shrestha, Biraj
Kewcharoen, Jakrin
Navaravong, Leenhapong
Kanjanauthai, Somsupha
Attanasio, Steve
Saudye, Hammad A.
author_sort Trongtorsak, Angkawipa
collection PubMed
description Previous studies have demonstrated gender disparities in mortality and vascular complications after transcatheter aortic valve replacement (TAVR) with early generation transcatheter heart valves (THVs). It is unclear, however, whether gender-related differences persist with the newer generation THVs. We aim to assess gender disparities after TAVR with newer generation THVs. The MEDLINE and Embase databases were thoroughly searched from inception to April 2023 to identify studies that reported gender-specific outcomes after TAVR with newer generation THVs (Sapien 3, Corevalve Evolut R, and Evolut Pro). The outcomes of interest included 30-day mortality, 1-year mortality, and vascular complications. In total, 5 studies (4 databases) with a total of 47,933 patients (21,073 females and 26,860 males) were included. Ninety-six percent received TAVR via the transfemoral approach. The females had higher 30-day mortality rates (odds ratio (OR) = 1.53, 95% confidence interval (CI) 1.31–1.79, p-value (p) < 0.001) and vascular complications (OR = 1.43, 95% CI 1.23–1.65, p < 0.001). However, one-year mortality was similar between the two groups (OR = 0.78, 95% CI 0.61–1.00, p = 0.28). The female gender continues to be associated with higher 30-day mortality rates and vascular complications after TAVR with newer generation transcatheter heart valves, while there was no difference in 1-year mortality between the genders. More data is needed to explore the causes and whether we can improve TAVR outcomes in females.
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spelling pubmed-102044432023-05-24 Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis Trongtorsak, Angkawipa Thangjui, Sittinun Adhikari, Pabitra Shrestha, Biraj Kewcharoen, Jakrin Navaravong, Leenhapong Kanjanauthai, Somsupha Attanasio, Steve Saudye, Hammad A. Med Sci (Basel) Systematic Review Previous studies have demonstrated gender disparities in mortality and vascular complications after transcatheter aortic valve replacement (TAVR) with early generation transcatheter heart valves (THVs). It is unclear, however, whether gender-related differences persist with the newer generation THVs. We aim to assess gender disparities after TAVR with newer generation THVs. The MEDLINE and Embase databases were thoroughly searched from inception to April 2023 to identify studies that reported gender-specific outcomes after TAVR with newer generation THVs (Sapien 3, Corevalve Evolut R, and Evolut Pro). The outcomes of interest included 30-day mortality, 1-year mortality, and vascular complications. In total, 5 studies (4 databases) with a total of 47,933 patients (21,073 females and 26,860 males) were included. Ninety-six percent received TAVR via the transfemoral approach. The females had higher 30-day mortality rates (odds ratio (OR) = 1.53, 95% confidence interval (CI) 1.31–1.79, p-value (p) < 0.001) and vascular complications (OR = 1.43, 95% CI 1.23–1.65, p < 0.001). However, one-year mortality was similar between the two groups (OR = 0.78, 95% CI 0.61–1.00, p = 0.28). The female gender continues to be associated with higher 30-day mortality rates and vascular complications after TAVR with newer generation transcatheter heart valves, while there was no difference in 1-year mortality between the genders. More data is needed to explore the causes and whether we can improve TAVR outcomes in females. MDPI 2023-05-09 /pmc/articles/PMC10204443/ /pubmed/37218985 http://dx.doi.org/10.3390/medsci11020033 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Trongtorsak, Angkawipa
Thangjui, Sittinun
Adhikari, Pabitra
Shrestha, Biraj
Kewcharoen, Jakrin
Navaravong, Leenhapong
Kanjanauthai, Somsupha
Attanasio, Steve
Saudye, Hammad A.
Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis
title Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis
title_full Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis
title_fullStr Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis
title_full_unstemmed Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis
title_short Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis
title_sort gender disparities after transcatheter aortic valve replacement with newer generation transcatheter heart valves: a systematic review and meta-analysis
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204443/
https://www.ncbi.nlm.nih.gov/pubmed/37218985
http://dx.doi.org/10.3390/medsci11020033
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