TY - JOUR

T1 - Sex Differences in Infective Endocarditis After Transcatheter Aortic Valve Replacement

AU - Panagides, Vassili

AU - Abdel-Wahab, Mohamed

AU - Mangner, Norman

AU - Durand, Eric

AU - Ihlemann, Nikolaj

AU - Urena, Marina

AU - Pellegrini, Costanza

AU - Giannini, Francesco

AU - Scislo, Piotr

AU - Huczek, Zenon

AU - Landt, Martin

AU - Auffret, Vincent

AU - Sinning, Jan Malte

AU - Cheema, Asim N.

AU - Nombela-Franco, Luis

AU - Chamandi, Chekrallah

AU - Campelo-Parada, Francisco

AU - Munoz-Garcia, Erika

AU - Herrmann, Howard C.

AU - Testa, Luca

AU - Kim, Won Keun

AU - Eltchaninoff, Helene

AU - Sondergaard, Lars

AU - Himbert, Dominique

AU - Husser, Oliver

AU - Latib, Azeem

AU - le Breton, Hervé

AU - Servoz, Clement

AU - Gervais, Philippe

AU - del Val, David

AU - Linke, Axel

AU - Crusius, Lisa

AU - Thiele, Holger

AU - Holzhey, David

AU - Rodés-Cabau, Josep

N1 - Funding Information: We acknowledge the Infectious Endocarditis After TAVR International Registry Investigators for their substantial contribution to data collection and research (the list of investigators is available in Supplemental Appendix S1). Dr Panagides has received a research grant from the “Mediterranean Academic Research and Studies in Cardiology” association. Dr Rodés-Cabau holds the Research Chair “Fondation Famille Jacques Larivière” for the development of structural heart disease interventions. The authors have no funding sources to declare. Dr Panagides has received institutional research grants from Medtronic, Boston Scientific, and Microport. Dr Mangner reports personal fees from Edwards Lifesciences, Medtronic, Biotronik, Novartis, Sanofi Genzyme, AstraZeneca, Pfizer, and Bayer, outside the submitted work. Dr Sinning reports speaker honouraria from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic and research grants from Boston Scientific, Edwards Lifesciences, and Medtronic, outside the submitted work. Dr Herrmann has received institutional research grants from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic and consulting fees from Edwards Lifesciences and Medtronic. Dr Kim reports personal fees from Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, and Meril, outside the submitted work. Dr Sondergaard has received consultant fees and/or institutional research grants from Abbott, Boston Scientific, Medtronic and SMT. Dr Husser reports personal fees from Boston Scientific and payments from Abbott. Dr Rodés-Cabau has received institutional research grants from Edwards Lifesciences, Medtronic, and Boston Scientific, and speaker fees from Edwards Lifesciences, Medtronic. The other authors have no conflicts of interest to disclose.

PY - 2022

Y1 - 2022

N2 - 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.

AB - 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.

U2 - 10.1016/j.cjca.2022.07.002

DO - 10.1016/j.cjca.2022.07.002

M3 - Journal article

C2 - 35842172

AN - SCOPUS:85137390223

VL - 38

SP - 1418

EP - 1425

JO - Canadian Journal of Cardiology

JF - Canadian Journal of Cardiology

SN - 0828-282X

IS - 9

ER -