Sex-Specific Disparities in Clinical Outcomes After Transcatheter Aortic Valve Replacement Among Different Racial Populations

Mijin Kim, Do Yoon Kang, Jung Min Ahn, Juyong Brian Kim, Alan C. Yeung, Takeshi Nishi, William F. Fearon, Eric Page Cantey, James D. Flaherty, Charles J Davidson, S. Christopher Malaisrie, Hwa Jung Kim, Jinho Lee, Jinsun Park, Hoyun Kim, Suji Cho, Yeonwoo Choi, Seung Jung Park, Duk Woo Park*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Sex-related disparities in clinical outcomes following transcatheter aortic valve replacement (TAVR) and the impact of sex on clinical outcomes after TAVR among different racial groups are undetermined. Objectives: This study assessed whether sex-specific differences in baseline clinical and anatomical characteristics affect clinical outcomes after TAVR and investigated the impact of sex on clinical outcomes among different racial groups. Methods: The TP-TAVR (Trans-Pacific TAVR) registry is a multinational cohort study of patients with severe aortic stenosis who underwent TAVR at 2 major centers in the United States and 1 major center in South Korea. The primary outcome was a composite of death from any cause, stroke, or rehospitalization after 1 year. Results: The incidence of the primary composite outcome was not significantly different between sexes (27.9% in men vs 28% in women; adjusted HR: 0.97; 95% CI: 0.79-1.20). This pattern was consistent in Asian (23.5% vs 23.3%; adjusted HR: 0.99; 95% CI: 0.69-1.41) and non-Asian (30.8% vs 31.6%; adjusted HR: 0.95; 95% CI: 0.72-1.24) cohorts, without a significant interaction between sex and racial group (P for interaction = 0.74). The adjusted risk for all-cause mortality was similar between sexes, regardless of racial group. However, the adjusted risk of stroke was significantly lower in male patients than in female patients, which was more prominent in the non-Asian cohort. Conclusions: Despite significantly different baseline and procedural characteristics, there were no sex-specific differences in the adjusted 1-year rates of primary composite outcomes and all-cause mortality, regardless of different racial groups.

Original languageEnglish (US)
Pages (from-to)292-302
Number of pages11
JournalJACC: Asia
Volume4
Issue number4
DOIs
StatePublished - Apr 2024

Keywords

  • TAVR
  • aortic valve stenosis
  • sex

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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