Navigation Links
Women 40% less likely to die after TAVI than men
Date:8/28/2012

Munich, Germany August 27 2012: Women with severe aortic stenosis are 40% less likely to die after transcatheter aortic valve implantation (TAVI) than men, reveals the latest data from the largest study to date of gender differences in outcomes after TAVI. The findings were presented at ESC Congress 2012 by Professor Karin Humphries from St. Paul's Hospital.

More than 1.5 million people in the US suffer from aortic stenosis, a progressive disease where the aortic valve becomes obstructed, leading to life-threatening heart problems. If left untreated, half of all patients do not survive for more than two years after the initial onset of symptoms. Traditionally, treatment involves open heart surgery to replace the diseased valve; however in frail and elderly patients the surgery is highly risky and sometimes simply not possible to perform.

A groundbreaking non-surgical treatment, known as transcatheter aortic valve implantation (TAVI), has shown considerable promise in these high-risk patients. Pioneered in Canada in 2005 by interventional cardiologist Dr John Webb and his team at St. Paul's Hospital in Vancouver, the TAVI procedure is minimally invasive and does not require major surgery.

Since the first successful valve implantation by Dr Alain Cribier from France, more than 50,000 procedures have been performed worldwide. To study the efficacy of the technique, researchers from the pivotal randomized trial, Placement of Aortic Transcatheter Valves (PARTNER) A, compared TAVI to traditional surgery and demonstrated patients did just as well with either procedure.

"The PARTNER trial also sparked considerable interest in gender differences," said Professor Humphries. "Women, at one year, were found to have lower mortality with TAVI when compared to men (1). However, the trial did not adjust for potential baseline differences between women and men. The US Food and Drug Administration's Circulatory Systems Devices Panel for the PARTNER trial has requested additional data on gender and longer-term results."

"Recent publications have sought to elucidate these gender differences in TAVI outcomes but have shown limited and conflicting results," she added. "A single centre study of 305 high-risk patients undergoing TAVI found no gender difference in 30-day mortality (2), while another study of 260 consecutive TAVI patients reported better 1-year survival in women, but failed to adjust for baseline differences (3)."

In response, Professor Humphries, in collaboration with colleagues from St. Paul's Hospital and Quebec's Laval Hospital, aimed to thoroughly examine gender differences in outcome after TAVI using real-world data from these two leading centres in TAVI procedures.

For this study, data from 641 consecutive, high-risk patients (51.3% women) with severe aortic stenosis undergoing TAVI between January 2005 and September 2011 were prospectively captured. Patients were followed for up to 2 years, with mortality as the primary outcome.

"One of the biggest challenges in cardiovascular disease research is that women typically constitute only 20-25% of the study population and there aren't enough numbers to determine whether treatment benefits extend to women," said Professor Humphries. "In our study women comprised more than half the cohort, perhaps because of the older age of subjects with severe aortic stenosis."

At baseline, women and men in the study population were of similar age, had similar aortic valve size in relation to their body size, and had similar extent of heart failure. Women had higher pressures across their aortic valve and worse kidney function but better ejection fractions. Men had more comorbidities such as prior heart attacks, prior revascularization, and chronic obstructive pulmonary disease (COPD).

After TAVI, women were more likely than men to experience serious procedural complications (12.4% vs. 5.4%) and major bleeds (21.6% vs. 15.8%). Yet, despite these adverse events, mortality remained lower in women at 30 days (6.5% vs. 11.2%).

Professor Humphries said: "We made extensive adjustments for demographic, procedural, and clinical differences between women and men to try and explain the observed gender difference. However, the female advantage persisted over the follow-up period with a hazard ratio of 0.60; meaning women were 40% less likely to die after receiving the treatment than men."

"Historically men have done better than women in almost all cardiac procedures," said Professor Humphries. "But for the first time, our study has shown women seem to benefit more than men after TAVI."

She added: "The results of the study, when considered in context of the PARTNER A trial findings, suggest TAVI might be the preferred mode of treatment in elderly women with symptomatic severe aortic stenosis."


'/>"/>

Contact: European Society of Cardiology
press@escardio.org
33-049-294-8627
European Society of Cardiology
Source:Eurekalert

Related medicine news :

1. Obese and overweight women face increased risk of recurrence of most common type of breast cancer
2. Brigham and Womens Hospital researchers initiate major cardiovascular inflammation reduction trial
3. Rosie ODonnells Heart Attack a Lesson for Women
4. RI Hospital researcher: Older women may not benefit from radiotherapy after breast surgery
5. New survey: Women want to SEE breast reconstruction results before cancer surgery
6. How well is depression in women being diagnosed and treated?
7. No evidence that drug used for preventing life-threatening bleeding in women during labor works
8. Tying the Knot Ups Womens Drinking Rate, Lowers Mens
9. Sleep Apnea Affects Many Women, Too
10. A Few Hours of Weekly Exercise May Help Womens Bones
11. Even minor physical activity may benefit bone health in premenopausal women
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... June 27, 2016 , ... "FCPX editors can now ... of Final Cut Pro X," said Christina Austin - CEO of Pixel Film Studios. ... Final Cut Pro X users can now reveal the media of their split ...
(Date:6/27/2016)... ... June 27, 2016 , ... A revolution is ... emergency ambulance transport experience for the millions of people who require these medical ... the taxi industry through the use of technology. Now, SmartEMS has put forth ...
(Date:6/26/2016)... ... June 26, 2016 , ... On June 10-11, 2016, A ... 2016 Cereal Festival and World’s Longest Breakfast Table in Battle Creek, MI, where the ... history as home to some of the world’s leading providers of cereal and other ...
(Date:6/26/2016)... ... , ... Brent Kasmer, a legally blind and certified personal trainer is helping to develop a ... fitness app plans to fix the two major problems leading the fitness industry today:, ... type program , They don’t eliminate all the reasons people quit their exercise ...
(Date:6/25/2016)... ... , ... Austin residents seeking Mohs surgery services, can now turn to Dr. ... Russell Peckham for medical and surgical dermatology. , Dr. Dorsey brings specialization to include ... in Mohs Micrographic Surgery completed by Dr. Dorsey was under the direction of Glenn ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... 2016   Bay Area Lyme Foundation , ... Center for Tick Borne Illness , Harvard Medical ... Hacking Medicine, University of California, Berkeley, and the ... five finalists of Lyme Innovation , the ... 100 scientists, clinicians, researchers, entrepreneurs, and investors from ...
(Date:6/24/2016)... June 24, 2016 The Academy of Managed ... recommendations that would allow biopharmaceutical companies to more ... that make formulary and coverage decisions, a move that ... new medicines. The recommendations address restrictions in ... on the drug label, a prohibition that hinders decision ...
(Date:6/24/2016)... 24, 2016 Research and Markets has ... Companion Diagnostic Tests" report to their offering. ... Diagnostics The World Market for Companion Diagnostics ... diagnostics. Market analysis in the report includes the following: ... Vitro Diagnostic Kits) by Region (N. America, EU, ROW), 2015-2020 ...
Breaking Medicine Technology: