Sex Differences in Infective Endocarditis After Transcatheter Aortic Valve Replacement

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 TestaWon Keun Kim, Helene Eltchaninoff, Lars Sondergaard, 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

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1418-1425
Number of pages8
JournalCanadian Journal of Cardiology
Issue number9
StatePublished - Sep 2022
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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