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Journal Articles Canadian Journal of Cardiology Year : 2022

Sex Differences in Infective Endocarditis After Transcatheter Aortic Valve Replacement

Vassili Panagides
Martin Landt
  • Function : Author

Abstract

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.
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Dates and versions

hal-03776230 , version 1 (16-09-2022)

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Vassili Panagides, Mohamed Abdel-Wahab, Norman Mangner, Eric Durand, Nikolaj Ihlemann, et al.. Sex Differences in Infective Endocarditis After Transcatheter Aortic Valve Replacement. Canadian Journal of Cardiology, 2022, 38 (9), pp.1418-1425. ⟨10.1016/j.cjca.2022.07.002⟩. ⟨hal-03776230⟩
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