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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Sex Differences in Infective Endocarditis After Transcatheter Aortic Valve Replacement
Vassili Panagides1, Mohamed Abdel-Wahab2, Norman Mangner3
1Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada.
The Canadian Journal of Cardiology
|July 16, 2022
Summary
Sex differences in infective endocarditis (IE) after transcatheter aortic valve replacement (TAVR) show similar initial management but higher long-term mortality for women. Female sex is an independent risk factor for cumulative mortality post-TAVR IE.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Outcomes
Background:
- Outcomes following transcatheter aortic valve replacement (TAVR) and infectious diseases can differ between sexes.
- Infective endocarditis (IE) is a serious complication after TAVR.
Purpose of the Study:
- To investigate sex-based disparities in clinical presentation, treatment strategies, and outcomes of IE in patients who underwent TAVR.
- To identify if female sex is associated with increased mortality risk after TAVR-related IE.
Main Methods:
- Retrospective analysis of 579 patients diagnosed with definite IE post-TAVR from the Infectious Endocarditis After TAVR International Registry.
- Comparison of clinical characteristics, microbiological data, management approaches, and mortality rates between men and women.
Main Results:
- Women were older and had fewer comorbidities. Culture-negative IE was more prevalent in women (9.9% vs 4.3%).
- Surgical intervention rates were low in both sexes. In-hospital mortality was similar, but women had higher 2-year cumulative mortality (63% vs 52.1%).
- Female sex was identified as an independent risk factor for cumulative mortality (aHR 1.28).
Conclusions:
- No significant sex differences were observed in the clinical characteristics or management of IE post-TAVR.
- Female sex is associated with a significantly increased risk of 2-year mortality following TAVR-related infective endocarditis.
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