Affiliation:
1. Department of Internal Medicine Faculty of Health Sciences Queen's University Kingston Ontario Canada
2. Division of Cardiac Surgery University of Manitoba Winnipeg Manitoba Canada
3. Department of Internal Medicine Faculty of Health Sciences McMaster University Hamilton Ontario Canada
4. Division of Cardiovascular Medicine, Gill Heart Institute University of Kentucky Lexington Kentucky USA
5. Division of Cardiovascular Medicine University of California San Francisco San Francisco USA
Abstract
AbstractBackgroundTranscatheter aortic valve replacement (TAVR) is a reasonable therapeutic approach among patients with symptomatic severe aortic stenosis irrespective of surgical risk. Data regarding sex‐specific differences in the outcomes with newer generation valves are limited.MethodsElectronic databases were searched for studies assessing sex differences in the outcomes of patients undergoing TAVR with newer generation valves (SAPIEN 3 or Evolut). Random effects model was constructed for summary estimates.ResultsFour observational studies with 4522 patients (44.8% women) were included in the meta‐analysis. Women were older and had a lower prevalence of coronary artery disease and mean EuroScore. Women had a higher incidence of short‐term mortality (up to 30 days) (risk ratio [RR]: 1.60, 95% confidence interval [CI]: 1.14–2.25), but no difference in 1‐year mortality (RR: 0.92, 95% CI: 0.72–1.17). There was no significant difference in the incidence of major bleeding (RR: 1.16, 95% CI: 0.86–1.57), permanent pacemaker (PPM) (RR: 0.80, 95% CI: 0.62–1.04), or disabling stroke (RR: 1.16, 95% CI: 0.54–2.45).ConclusionIn this meta‐analysis, we found that women undergoing TAVR with newer‐generation devices were older but had a lower prevalence of comorbidities. Women had a higher incidence of short‐term mortality but no difference in the 1‐year mortality, bleeding, PPM, or stroke compared with men. Future studies are required to confirm these findings.