Sex-related Differences among Patients Undergoing Surgical Aortic Valve Replacement - A Propensity Score Matched Study

Andreas Zierer; Ruggero De Paulis; Farhad Bakhtiary; Ali El-Sayed Ahmad; Martin Andreas; Rüdiger Autschbach; Peter Benedikt; Konrad Binder; Nikolaos Bonaros; Michael Borger; Thierry Bourguignon; Sergio Canovas; Enrico Coscioni; Francois Dagenais; Philippe Demers; Oliver Dewald; Richard Feyrer; Hans-Joachim Geißler; Martin Grabenwöger; Jürg Grünenfelder; Sami Kueri; Ka Yan Lam; Thierry Langanay; Günther Laufer; Wouter Van Leeuwen; Rainer Leyh; Andreas Liebold; Giovanni Mariscalco; Parwis Massoudy; Arash Mehdiani; Renzo Pessotto; Francesco Pollari; Gianluca Polvani; Alessandro Ricci; Jean-Christian Roussel; Saad Salamate; Matthias Siepe; Pierluigi Stefano; Justus Strauch; Alexis Theron; Andreas Vötsch; Alberto Weber; Olaf Wendler; Matthias Thielmann; Matthias Eden; Beate Botta; Peter Bramlage; Bart Meuris

doi:10.1093/icvts/ivae140

Sex-related Differences among Patients Undergoing Surgical Aortic Valve Replacement - A Propensity Score Matched Study

Andreas Zierer, Ruggero De Paulis, Farhad Bakhtiary, Ali El-Sayed Ahmad, Martin Andreas, Rüdiger Autschbach, Peter Benedikt, Konrad Binder, Nikolaos Bonaros, Michael Borger, Thierry Bourguignon, Sergio Canovas, Enrico Coscioni, Francois Dagenais, Philippe Demers, Oliver Dewald, Richard Feyrer, Hans-Joachim Geißler, Martin Grabenwöger, Jürg GrünenfelderSami Kueri, Ka Yan Lam, Thierry Langanay, Günther Laufer, Wouter Van Leeuwen, Rainer Leyh, Andreas Liebold, Giovanni Mariscalco, Parwis Massoudy, Arash Mehdiani, Renzo Pessotto, Francesco Pollari, Gianluca Polvani, Alessandro Ricci, Jean-Christian Roussel, Saad Salamate, Matthias Siepe, Pierluigi Stefano, Justus Strauch, Alexis Theron, Andreas Vötsch, Alberto Weber, Olaf Wendler, Matthias Thielmann, Matthias Eden, Beate Botta, Peter Bramlage, Bart Meuris

Division of Cardiosurgery (University Hospital St. Pölten)

Research output: Journal article (peer-reviewed) › Journal article

Abstract

OBJECTIVES: We investigated the sex-related difference in characteristics and 2-year outcomes after surgical aortic valve replacement (SAVR) by propensity-score matching (PSM).

METHODS: Data from two prospective registries, INDURE and IMPACT, were merged, resulting in a total of 933 patients: 735 males and 253 females undergoing first-time SAVR. PSM was performed to assess the impact of sex on the SAVR outcomes, yielding 433 males and 243 females with comparable baseline characteristics.

RESULTS: Females had a lower body mass index (BMI; median 27.1 vs 28.0 kg/m2; p = 0.008), fewer bicuspid valves (52% vs 59%; p = 0.036), higher EuroSCORE II (mean 2.3 vs 1.8%; p < 0.001) and STS score (mean 1.6 vs 0.9%; p < 0.001), were more often in NYHA class III/IV (47% vs 30%; p < 0.001) and angina CCS III/IV (8.2% vs 4.4%; p < 0.001), but had a lower rate of myocardial infarction (1.9% vs 5.2%; p = 0.028) compared to males. These differences vanished after PSM, except for EuroSCORE II and STS scores, which were still significantly higher in females. Furthermore, females required smaller valves (median diameter 23.0 vs 25.0 mm, p < 0.001). There were no differences in the length of hospital stay (median 8 days) or ICU stay (median 24 vs 25 hours) between both sexes. At two years, post-SAVR outcomes were comparable between males and females, even after PSM.

CONCLUSIONS: Despite females presenting with a significantly higher surgical risk profile, 2-year outcomes following SAVR were comparable between males and females.

Original language	English
Article number	ivae140
Journal	Interdisciplinary cardiovascular and thoracic surgery
Volume	39
Issue number	2
DOIs	https://doi.org/10.1093/icvts/ivae140
Publication status	Accepted/In press - 10 Aug 2024

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10.1093/icvts/ivae140

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Zierer, A., De Paulis, R., Bakhtiary, F., Ahmad, A. E.-S., Andreas, M., Autschbach, R., Benedikt, P., Binder, K., Bonaros, N., Borger, M., Bourguignon, T., Canovas, S., Coscioni, E., Dagenais, F., Demers, P., Dewald, O., Feyrer, R., Geißler, H.-J., Grabenwöger, M., ... Meuris, B. (Accepted/In press). Sex-related Differences among Patients Undergoing Surgical Aortic Valve Replacement - A Propensity Score Matched Study. Interdisciplinary cardiovascular and thoracic surgery, 39(2), Article ivae140. https://doi.org/10.1093/icvts/ivae140

@article{71fc21a824e04fee8f8b4c63a8fd0a18,

title = "Sex-related Differences among Patients Undergoing Surgical Aortic Valve Replacement - A Propensity Score Matched Study",

abstract = "OBJECTIVES: We investigated the sex-related difference in characteristics and 2-year outcomes after surgical aortic valve replacement (SAVR) by propensity-score matching (PSM).METHODS: Data from two prospective registries, INDURE and IMPACT, were merged, resulting in a total of 933 patients: 735 males and 253 females undergoing first-time SAVR. PSM was performed to assess the impact of sex on the SAVR outcomes, yielding 433 males and 243 females with comparable baseline characteristics.RESULTS: Females had a lower body mass index (BMI; median 27.1 vs 28.0 kg/m2; p = 0.008), fewer bicuspid valves (52% vs 59%; p = 0.036), higher EuroSCORE II (mean 2.3 vs 1.8%; p < 0.001) and STS score (mean 1.6 vs 0.9%; p < 0.001), were more often in NYHA class III/IV (47% vs 30%; p < 0.001) and angina CCS III/IV (8.2% vs 4.4%; p < 0.001), but had a lower rate of myocardial infarction (1.9% vs 5.2%; p = 0.028) compared to males. These differences vanished after PSM, except for EuroSCORE II and STS scores, which were still significantly higher in females. Furthermore, females required smaller valves (median diameter 23.0 vs 25.0 mm, p < 0.001). There were no differences in the length of hospital stay (median 8 days) or ICU stay (median 24 vs 25 hours) between both sexes. At two years, post-SAVR outcomes were comparable between males and females, even after PSM.CONCLUSIONS: Despite females presenting with a significantly higher surgical risk profile, 2-year outcomes following SAVR were comparable between males and females.",

author = "Andreas Zierer and {De Paulis}, Ruggero and Farhad Bakhtiary and Ahmad, {Ali El-Sayed} and Martin Andreas and R{\"u}diger Autschbach and Peter Benedikt and Konrad Binder and Nikolaos Bonaros and Michael Borger and Thierry Bourguignon and Sergio Canovas and Enrico Coscioni and Francois Dagenais and Philippe Demers and Oliver Dewald and Richard Feyrer and Hans-Joachim Gei{\ss}ler and Martin Grabenw{\"o}ger and J{\"u}rg Gr{\"u}nenfelder and Sami Kueri and Lam, {Ka Yan} and Thierry Langanay and G{\"u}nther Laufer and {Van Leeuwen}, Wouter and Rainer Leyh and Andreas Liebold and Giovanni Mariscalco and Parwis Massoudy and Arash Mehdiani and Renzo Pessotto and Francesco Pollari and Gianluca Polvani and Alessandro Ricci and Jean-Christian Roussel and Saad Salamate and Matthias Siepe and Pierluigi Stefano and Justus Strauch and Alexis Theron and Andreas V{\"o}tsch and Alberto Weber and Olaf Wendler and Matthias Thielmann and Matthias Eden and Beate Botta and Peter Bramlage and Bart Meuris",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2024.",

year = "2024",

month = aug,

day = "10",

doi = "10.1093/icvts/ivae140",

language = "English",

volume = "39",

journal = "Interdisciplinary cardiovascular and thoracic surgery",

issn = "2753-670X",

number = "2",

}

Zierer, A, De Paulis, R, Bakhtiary, F, Ahmad, AE-S, Andreas, M, Autschbach, R, Benedikt, P, Binder, K, Bonaros, N, Borger, M, Bourguignon, T, Canovas, S, Coscioni, E, Dagenais, F, Demers, P, Dewald, O, Feyrer, R, Geißler, H-J, Grabenwöger, M, Grünenfelder, J, Kueri, S, Lam, KY, Langanay, T, Laufer, G, Van Leeuwen, W, Leyh, R, Liebold, A, Mariscalco, G, Massoudy, P, Mehdiani, A, Pessotto, R, Pollari, F, Polvani, G, Ricci, A, Roussel, J-C, Salamate, S, Siepe, M, Stefano, P, Strauch, J, Theron, A, Vötsch, A, Weber, A, Wendler, O, Thielmann, M, Eden, M, Botta, B, Bramlage, P & Meuris, B 2024, 'Sex-related Differences among Patients Undergoing Surgical Aortic Valve Replacement - A Propensity Score Matched Study', Interdisciplinary cardiovascular and thoracic surgery, vol. 39, no. 2, ivae140. https://doi.org/10.1093/icvts/ivae140

TY - JOUR

T1 - Sex-related Differences among Patients Undergoing Surgical Aortic Valve Replacement - A Propensity Score Matched Study

AU - Zierer, Andreas

AU - De Paulis, Ruggero

AU - Bakhtiary, Farhad

AU - Ahmad, Ali El-Sayed

AU - Andreas, Martin

AU - Autschbach, Rüdiger

AU - Benedikt, Peter

AU - Binder, Konrad

AU - Bonaros, Nikolaos

AU - Borger, Michael

AU - Bourguignon, Thierry

AU - Canovas, Sergio

AU - Coscioni, Enrico

AU - Dagenais, Francois

AU - Demers, Philippe

AU - Dewald, Oliver

AU - Feyrer, Richard

AU - Geißler, Hans-Joachim

AU - Grabenwöger, Martin

AU - Grünenfelder, Jürg

AU - Kueri, Sami

AU - Lam, Ka Yan

AU - Langanay, Thierry

AU - Laufer, Günther

AU - Van Leeuwen, Wouter

AU - Leyh, Rainer

AU - Liebold, Andreas

AU - Mariscalco, Giovanni

AU - Massoudy, Parwis

AU - Mehdiani, Arash

AU - Pessotto, Renzo

AU - Pollari, Francesco

AU - Polvani, Gianluca

AU - Ricci, Alessandro

AU - Roussel, Jean-Christian

AU - Salamate, Saad

AU - Siepe, Matthias

AU - Stefano, Pierluigi

AU - Strauch, Justus

AU - Theron, Alexis

AU - Vötsch, Andreas

AU - Weber, Alberto

AU - Wendler, Olaf

AU - Thielmann, Matthias

AU - Eden, Matthias

AU - Botta, Beate

AU - Bramlage, Peter

AU - Meuris, Bart

PY - 2024/8/10

Y1 - 2024/8/10

N2 - OBJECTIVES: We investigated the sex-related difference in characteristics and 2-year outcomes after surgical aortic valve replacement (SAVR) by propensity-score matching (PSM).METHODS: Data from two prospective registries, INDURE and IMPACT, were merged, resulting in a total of 933 patients: 735 males and 253 females undergoing first-time SAVR. PSM was performed to assess the impact of sex on the SAVR outcomes, yielding 433 males and 243 females with comparable baseline characteristics.RESULTS: Females had a lower body mass index (BMI; median 27.1 vs 28.0 kg/m2; p = 0.008), fewer bicuspid valves (52% vs 59%; p = 0.036), higher EuroSCORE II (mean 2.3 vs 1.8%; p < 0.001) and STS score (mean 1.6 vs 0.9%; p < 0.001), were more often in NYHA class III/IV (47% vs 30%; p < 0.001) and angina CCS III/IV (8.2% vs 4.4%; p < 0.001), but had a lower rate of myocardial infarction (1.9% vs 5.2%; p = 0.028) compared to males. These differences vanished after PSM, except for EuroSCORE II and STS scores, which were still significantly higher in females. Furthermore, females required smaller valves (median diameter 23.0 vs 25.0 mm, p < 0.001). There were no differences in the length of hospital stay (median 8 days) or ICU stay (median 24 vs 25 hours) between both sexes. At two years, post-SAVR outcomes were comparable between males and females, even after PSM.CONCLUSIONS: Despite females presenting with a significantly higher surgical risk profile, 2-year outcomes following SAVR were comparable between males and females.

AB - OBJECTIVES: We investigated the sex-related difference in characteristics and 2-year outcomes after surgical aortic valve replacement (SAVR) by propensity-score matching (PSM).METHODS: Data from two prospective registries, INDURE and IMPACT, were merged, resulting in a total of 933 patients: 735 males and 253 females undergoing first-time SAVR. PSM was performed to assess the impact of sex on the SAVR outcomes, yielding 433 males and 243 females with comparable baseline characteristics.RESULTS: Females had a lower body mass index (BMI; median 27.1 vs 28.0 kg/m2; p = 0.008), fewer bicuspid valves (52% vs 59%; p = 0.036), higher EuroSCORE II (mean 2.3 vs 1.8%; p < 0.001) and STS score (mean 1.6 vs 0.9%; p < 0.001), were more often in NYHA class III/IV (47% vs 30%; p < 0.001) and angina CCS III/IV (8.2% vs 4.4%; p < 0.001), but had a lower rate of myocardial infarction (1.9% vs 5.2%; p = 0.028) compared to males. These differences vanished after PSM, except for EuroSCORE II and STS scores, which were still significantly higher in females. Furthermore, females required smaller valves (median diameter 23.0 vs 25.0 mm, p < 0.001). There were no differences in the length of hospital stay (median 8 days) or ICU stay (median 24 vs 25 hours) between both sexes. At two years, post-SAVR outcomes were comparable between males and females, even after PSM.CONCLUSIONS: Despite females presenting with a significantly higher surgical risk profile, 2-year outcomes following SAVR were comparable between males and females.

UR - http://www.scopus.com/inward/record.url?scp=85202025811&partnerID=8YFLogxK

U2 - 10.1093/icvts/ivae140

DO - 10.1093/icvts/ivae140

M3 - Journal article

C2 - 39128016

SN - 2753-670X

VL - 39

JO - Interdisciplinary cardiovascular and thoracic surgery

JF - Interdisciplinary cardiovascular and thoracic surgery

IS - 2

M1 - ivae140

ER -

Sex-related Differences among Patients Undergoing Surgical Aortic Valve Replacement - A Propensity Score Matched Study

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