Sex Differences in Infective Endocarditis After Transcatheter Aortic Valve Replacement

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Vassili Panagides
  • Mohamed Abdel-Wahab
  • Norman Mangner
  • Eric Durand
  • Nikolaj Ihlemann
  • Marina Urena
  • Costanza Pellegrini
  • Francesco Giannini
  • Piotr Scislo
  • Zenon Huczek
  • Martin Landt
  • Vincent Auffret
  • Jan Malte Sinning
  • Asim N. Cheema
  • Luis Nombela-Franco
  • Chekrallah Chamandi
  • Francisco Campelo-Parada
  • Erika Munoz-Garcia
  • Howard C. Herrmann
  • Luca Testa
  • Won Keun Kim
  • Helene Eltchaninoff
  • Dominique Himbert
  • Oliver Husser
  • Azeem Latib
  • Hervé le Breton
  • Clement Servoz
  • Philippe Gervais
  • David del Val
  • Axel Linke
  • Lisa Crusius
  • Holger Thiele
  • David Holzhey
  • Josep Rodés-Cabau

Background: Outcomes after transcatheter aortic valve replacement (TAVR) and infectious diseases may vary according to sex. Methods: This multicentre study aimed to determine the sex differences in clinical characteristics, management, and outcomes of infective endocarditis (IE) after TAVR. A total of 579 patients (217 women, 37.5%) who had the diagnosis of definite IE following TAVR were included retrospectively from the Infectious Endocarditis After TAVR International Registry. Results: Women were older (80 ± 8 vs 78 ± 8 years; P = 0.001) and exhibited a lower comorbidity burden. Clinical characteristics and microbiological profiles were similar between men and women, but culture-negative IE was more frequent in women (9.9% vs 4.3%; P = 0.009). A high proportion of patients had a clinical indication for surgery (54.4% in both groups; P = 0.99), but a surgical intervention was performed in a minority of patients (women 15.2%, men 20.3%; P = 0.13). The mortality rate at index IE hospitalisation was similar in both groups (women 35.4%, men 31.7%; P = 0.37), but women exhibited a higher mortality rate at 2-year follow-up (63% vs 52.1%; P = 0.021). Female sex remained an independent risk factor for cumulative mortality in the multivariable analysis (adjusted HR 1.28, 95% CI 1.02-1.62; P = 0.035). After adjustment for in-hospital events, surgery was not associated with better outcomes in women. Conclusions: There were no significant sex-related differences in the clinical characteristics and management of IE after TAVR. However, female sex was associated with increased 2-year mortality risk.

OriginalsprogEngelsk
TidsskriftCanadian Journal of Cardiology
Vol/bind38
Udgave nummer9
Sider (fra-til)1418-1425
ISSN0828-282X
DOI
StatusUdgivet - 2022

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© 2022 Canadian Cardiovascular Society

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