Sex-related differences in outcomes after transcatheter aortic valve
implantation: a systematic review and meta-analysis.
Abstract
Background: Complications and outcomes after TAVI differ
considerably between men and women. Methods: We searched the
Cochrane Library, PubMed, Embase, and the Web of Science from January
2000 to January 2022. Gender-related articles reporting complications
and mortality after TAVI were identified. This meta-analysis analyzed
differences between women and men in postoperative outcome measures,
early survival, and one-year survival. Results: There were 18
studies, a total of 80632 patients, enrolled in our systematic review
and meta-analysis, including 37775 men and 42857 women. Comprehensive
analysis showed significant differences in gender in complications and
early and medium-term results after TAVI. Men had a significantly lower
risk of major bleeding (RR, 0.67; p=0.001), major vascular complications
(RR, 0.66; p=0.0002), and stroke (RR, 0.84; p=0.008). Although the
short-term survival rate of men is slightly higher than that of women
(RR, 0.83; p<0.00001), the prognosis is poor in mid-term survival (RR,
1.08; p=0.02). Conclusions: The medium-term survival rate for
men after TAVI is lower than for women, despite men having a lower risk
of major bleeding, major vascular complications, and stroke.