"Effect of sex and low flow after surgical or transcatheter aortic valv" by Marie-Annick Clavel, Rebecca T. Hahn et al.
 

Effect of sex and low flow after surgical or transcatheter aortic valve replacement: an analysis of partner 2 and 3 trials

Document Type

Conference Proceeding

Publication Date

3-2022

Publication Title

Journal of the American College of Cardiology

Abstract

Background: Low flow (LF), defined as stroke volume index (SVi) ≤35 ml/m2, following transcatheter or surgical aortic valve replacement (TAVR or SAVR) in patients with severe aortic stenosis (AS) is associated with adverse outcomes. Sex-specific thresholds for LF (i.e., SVi ≤35 ml/m2 in women and SVi ≤40 ml/m2 in men) may better stratify risk.

Methods: Patients from the PARTNER 2 and 3 trials were stratified by sex and treatment arm. Those with LF were identified using both the standard and sex-specific definitions. The composite rate of death or heart failure hospitalization (HFH) two years post-intervention was compared between groups.

Results: Of the 1,717 men and 1,044 women available for analysis, LF was more common in men than women, by both the standard (37.3% vs. 30.2%; p=0.001) and sex-specific (60.2% vs. 19.4%; p< 0.001) thresholds. Compared to the standard threshold, sex-specific LF thresholds better stratified risk of the composite endpoint, especially in women (log-rank p=0.004 vs. 0.04). LF defined by sex-specific (Figure) or standard thresholds was predictive of the composite endpoint in men after TAVR (both p=0.004) and SAVR (p=0.08 or p=0.01) and in women only after SAVR (p=0.008 or p=0.02). Analyses focused on death alone had similar results.

Conclusion:Sex-specific thresholds for LF may better stratify risk of death or HFH after AVR for AS, compared to a standard threshold for both sexes. In women with LF, TAVR may improve outcomes compared to SAVR. Further study is needed.

Volume

79

Issue

9 Supplement

First Page

717

Link to Full Text

Share

COinS