Does Gender Influence the Indication of Treatment and Long-Term Prognosis in Severe Aortic Stenosis?
Introduction: It is a matter of controversy whether the therapeutic strategy for severe aortic stenosis (AS) differs according to gender. Methods: Retrospective study of patients diagnosed with severe AS (transvalvular mean gradient ≥ 40 mmHg and/or aortic valvular area < 1 cm<sup>2</sup...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-01-01
|
| Series: | Journal of Cardiovascular Development and Disease |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2308-3425/10/2/38 |
| _version_ | 1827757123066396672 |
|---|---|
| author | Celia Gil Llopis Amparo Valls Serral Ildefonso Roldán Torres Maria Belén Contreras Tornero Ana Cuevas Vilaplana Adrian Sorribes Alonso Pablo Escribano Escribano Pau Gimeno Tio Esther Galiana Talavera Juan Geraldo Martínez Paula Gramage Sanchis Alberto Hidalgo Mateos Vicente Mora Llabata |
| author_facet | Celia Gil Llopis Amparo Valls Serral Ildefonso Roldán Torres Maria Belén Contreras Tornero Ana Cuevas Vilaplana Adrian Sorribes Alonso Pablo Escribano Escribano Pau Gimeno Tio Esther Galiana Talavera Juan Geraldo Martínez Paula Gramage Sanchis Alberto Hidalgo Mateos Vicente Mora Llabata |
| author_sort | Celia Gil Llopis |
| collection | DOAJ |
| description | Introduction: It is a matter of controversy whether the therapeutic strategy for severe aortic stenosis (AS) differs according to gender. Methods: Retrospective study of patients diagnosed with severe AS (transvalvular mean gradient ≥ 40 mmHg and/or aortic valvular area < 1 cm<sup>2</sup>) between 2009 and 2019. Our aim was to assess the association of sex on AVR or medical management and outcomes in patients with severe AS. Results: 452 patients were included. Women (51.1%) were older than men (80 ± 8.4 vs. 75.8 ± 9.9 years; <i>p</i> < 0.001). Aortic valve replacement (AVR) was performed less frequently in women (43.4% vs. 53.2%; <i>p</i> = 0.03), but multivariate analyses showed that sex was not an independent predictor factor for AVR. Age, Charlson index and symptoms were predictive factors (OR 0.81 [0.82–0.89], OR 0.81 [0.71–0.93], OR 22.02 [6.77–71.64]). Survival analysis revealed no significant association of sex within all-cause and cardiovascular mortalities (log-rank <i>p</i> = 0.63 and <i>p</i> = 0.07). Cox proportional hazards analyses showed AVR (HR: 0.1 [0.06–0.15]), Charlson index (HR: 1.13 [1.06–1.21]) and reduced LVEF (HR: 1.9 [1.32–2.73]) to be independent cardiovascular mortality predictors. Conclusions: Gender is not associated with AVR or long-term prognosis. Cardiovascular mortality was associated with older age, more comorbidity and worse LVEF. |
| first_indexed | 2024-03-11T08:39:15Z |
| format | Article |
| id | doaj.art-fc5058c405774daa851ea54f56b931ce |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-11T08:39:15Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-fc5058c405774daa851ea54f56b931ce2023-11-16T21:16:10ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252023-01-011023810.3390/jcdd10020038Does Gender Influence the Indication of Treatment and Long-Term Prognosis in Severe Aortic Stenosis?Celia Gil Llopis0Amparo Valls Serral1Ildefonso Roldán Torres2Maria Belén Contreras Tornero3Ana Cuevas Vilaplana4Adrian Sorribes Alonso5Pablo Escribano Escribano6Pau Gimeno Tio7Esther Galiana Talavera8Juan Geraldo Martínez9Paula Gramage Sanchis10Alberto Hidalgo Mateos11Vicente Mora Llabata12Department of Cardiology, Hospital Universitario Dr Peset, 46017 Valencia, SpainDepartment of Cardiology, Hospital Universitario Dr Peset, 46017 Valencia, SpainDepartment of Cardiology, Hospital Universitario Dr Peset, 46017 Valencia, SpainDepartment of Cardiology, Hospital Universitario Dr Peset, 46017 Valencia, SpainDepartment of Cardiology, Hospital Universitario Dr Peset, 46017 Valencia, SpainDepartment of Cardiology, Hospital Universitario Dr Peset, 46017 Valencia, SpainDepartment of Cardiology, Hospital Universitario Dr Peset, 46017 Valencia, SpainDepartment of Cardiology, Hospital Universitario Dr Peset, 46017 Valencia, SpainDepartment of Cardiology, Hospital Universitario Dr Peset, 46017 Valencia, SpainDepartment of Cardiology, Hospital Universitario Dr Peset, 46017 Valencia, SpainDepartment of Cardiology, Hospital Universitario Dr Peset, 46017 Valencia, SpainDepartment of Cardiology, Hospital Universitario Dr Peset, 46017 Valencia, SpainDepartment of Cardiology, Hospital Universitario Dr Peset, 46017 Valencia, SpainIntroduction: It is a matter of controversy whether the therapeutic strategy for severe aortic stenosis (AS) differs according to gender. Methods: Retrospective study of patients diagnosed with severe AS (transvalvular mean gradient ≥ 40 mmHg and/or aortic valvular area < 1 cm<sup>2</sup>) between 2009 and 2019. Our aim was to assess the association of sex on AVR or medical management and outcomes in patients with severe AS. Results: 452 patients were included. Women (51.1%) were older than men (80 ± 8.4 vs. 75.8 ± 9.9 years; <i>p</i> < 0.001). Aortic valve replacement (AVR) was performed less frequently in women (43.4% vs. 53.2%; <i>p</i> = 0.03), but multivariate analyses showed that sex was not an independent predictor factor for AVR. Age, Charlson index and symptoms were predictive factors (OR 0.81 [0.82–0.89], OR 0.81 [0.71–0.93], OR 22.02 [6.77–71.64]). Survival analysis revealed no significant association of sex within all-cause and cardiovascular mortalities (log-rank <i>p</i> = 0.63 and <i>p</i> = 0.07). Cox proportional hazards analyses showed AVR (HR: 0.1 [0.06–0.15]), Charlson index (HR: 1.13 [1.06–1.21]) and reduced LVEF (HR: 1.9 [1.32–2.73]) to be independent cardiovascular mortality predictors. Conclusions: Gender is not associated with AVR or long-term prognosis. Cardiovascular mortality was associated with older age, more comorbidity and worse LVEF.https://www.mdpi.com/2308-3425/10/2/38aortic valve stenosissex differencesaortic valve replacementmortalitytreatment outcome |
| spellingShingle | Celia Gil Llopis Amparo Valls Serral Ildefonso Roldán Torres Maria Belén Contreras Tornero Ana Cuevas Vilaplana Adrian Sorribes Alonso Pablo Escribano Escribano Pau Gimeno Tio Esther Galiana Talavera Juan Geraldo Martínez Paula Gramage Sanchis Alberto Hidalgo Mateos Vicente Mora Llabata Does Gender Influence the Indication of Treatment and Long-Term Prognosis in Severe Aortic Stenosis? Journal of Cardiovascular Development and Disease aortic valve stenosis sex differences aortic valve replacement mortality treatment outcome |
| title | Does Gender Influence the Indication of Treatment and Long-Term Prognosis in Severe Aortic Stenosis? |
| title_full | Does Gender Influence the Indication of Treatment and Long-Term Prognosis in Severe Aortic Stenosis? |
| title_fullStr | Does Gender Influence the Indication of Treatment and Long-Term Prognosis in Severe Aortic Stenosis? |
| title_full_unstemmed | Does Gender Influence the Indication of Treatment and Long-Term Prognosis in Severe Aortic Stenosis? |
| title_short | Does Gender Influence the Indication of Treatment and Long-Term Prognosis in Severe Aortic Stenosis? |
| title_sort | does gender influence the indication of treatment and long term prognosis in severe aortic stenosis |
| topic | aortic valve stenosis sex differences aortic valve replacement mortality treatment outcome |
| url | https://www.mdpi.com/2308-3425/10/2/38 |
| work_keys_str_mv | AT celiagilllopis doesgenderinfluencetheindicationoftreatmentandlongtermprognosisinsevereaorticstenosis AT amparovallsserral doesgenderinfluencetheindicationoftreatmentandlongtermprognosisinsevereaorticstenosis AT ildefonsoroldantorres doesgenderinfluencetheindicationoftreatmentandlongtermprognosisinsevereaorticstenosis AT mariabelencontrerastornero doesgenderinfluencetheindicationoftreatmentandlongtermprognosisinsevereaorticstenosis AT anacuevasvilaplana doesgenderinfluencetheindicationoftreatmentandlongtermprognosisinsevereaorticstenosis AT adriansorribesalonso doesgenderinfluencetheindicationoftreatmentandlongtermprognosisinsevereaorticstenosis AT pabloescribanoescribano doesgenderinfluencetheindicationoftreatmentandlongtermprognosisinsevereaorticstenosis AT paugimenotio doesgenderinfluencetheindicationoftreatmentandlongtermprognosisinsevereaorticstenosis AT esthergalianatalavera doesgenderinfluencetheindicationoftreatmentandlongtermprognosisinsevereaorticstenosis AT juangeraldomartinez doesgenderinfluencetheindicationoftreatmentandlongtermprognosisinsevereaorticstenosis AT paulagramagesanchis doesgenderinfluencetheindicationoftreatmentandlongtermprognosisinsevereaorticstenosis AT albertohidalgomateos doesgenderinfluencetheindicationoftreatmentandlongtermprognosisinsevereaorticstenosis AT vicentemorallabata doesgenderinfluencetheindicationoftreatmentandlongtermprognosisinsevereaorticstenosis |