Sex-related differences among patients undergoing surgical aortic valve replacement-a propensity score matched study

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Medical Research

Background:

• Sex-based differences in cardiovascular disease presentation and outcomes are increasingly recognized.
• Surgical aortic valve replacement (SAVR) is a common procedure, but sex-related disparities in outcomes require further investigation.

Purpose of the Study:

• To investigate sex-related differences in patient characteristics and 2-year outcomes following SAVR.
• To assess the impact of sex on SAVR outcomes using propensity-score matching (PSM).

Main Methods:

• Data from two prospective registries (INSPIRIS RESILIA Durability Registry and IMPACT) were merged.
• Propensity-score matching (PSM) was used to create comparable cohorts of male and female patients undergoing first-time SAVR.
• Baseline characteristics, procedural details, and 2-year clinical outcomes were analyzed.

Main Results:

• Females had a higher surgical risk profile (higher EuroSCORE II and STS scores) and required smaller aortic valves compared to males.
• Despite these differences, most baseline disparities vanished after PSM, except for higher risk scores in females.
• No significant differences in hospital stay, ICU stay, or 2-year post-SAVR outcomes were observed between sexes after PSM.

Conclusions:

• Females undergoing SAVR present with a higher surgical risk profile but achieve comparable 2-year outcomes to males.
• These findings suggest that SAVR is an effective treatment for both sexes, irrespective of baseline risk differences.