TY - JOUR
T1 - Sex Differences in Infective Endocarditis After Transcatheter Aortic Valve Replacement
AU - Panagides, Vassili
AU - Abdel-Wahab, Mohamed
AU - Mangner, Norman
AU - Durand, Eric
AU - Ihlemann, Nikolaj
AU - Urena, Marina
AU - Pellegrini, Costanza
AU - Giannini, Francesco
AU - Scislo, Piotr
AU - Huczek, Zenon
AU - Landt, Martin
AU - Auffret, Vincent
AU - Sinning, Jan Malte
AU - Cheema, Asim N.
AU - Nombela-Franco, Luis
AU - Chamandi, Chekrallah
AU - Campelo-Parada, Francisco
AU - Munoz-Garcia, Erika
AU - Herrmann, Howard C.
AU - Testa, Luca
AU - Kim, Won Keun
AU - Eltchaninoff, Helene
AU - Sondergaard, Lars
AU - Himbert, Dominique
AU - Husser, Oliver
AU - Latib, Azeem
AU - le Breton, Hervé
AU - Servoz, Clement
AU - Gervais, Philippe
AU - del Val, David
AU - Linke, Axel
AU - Crusius, Lisa
AU - Thiele, Holger
AU - Holzhey, David
AU - Rodés-Cabau, Josep
N1 - Publisher Copyright:
© 2022 Canadian Cardiovascular Society
PY - 2022/9
Y1 - 2022/9
N2 - 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.
AB - 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.
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U2 - 10.1016/j.cjca.2022.07.002
DO - 10.1016/j.cjca.2022.07.002
M3 - Article
C2 - 35842172
AN - SCOPUS:85137390223
SN - 0828-282X
VL - 38
SP - 1418
EP - 1425
JO - Canadian Journal of Cardiology
JF - Canadian Journal of Cardiology
IS - 9
ER -