Valvular & structural heart diseaseCohort study
Association of Age and Sex With Use of Transcatheter Aortic Valve Replacement in France
- Retrospective cohort study
- nationwide administrative database
Authors' conclusion
In France, the use of TAVR remained uncommon in young patients, predominantly restricted to those at high risk. Important sex differences were observed in patent demographics, selection of AVR modality, and patient outcomes.
Study context
- Population
- Patients undergoing isolated aortic valve replacement (AVR) in France, 2015–202044.0% female
- Participants
- 107,397 patients
- Exposure
- Transcatheter aortic valve replacement (TAVR) vs surgical aortic valve replacement (SAVR) uptake by age and sex
- Outcome
- Age- and sex-related trends in TAVR uptake, patient demographics and in-hospital outcomes
- Follow-up
- 2015–2020
Main finding
As reported in the abstract
Proportion of TAVR among AVR
| Group | Value | Females (2020) | Males (2020) | Increase 2015 to 2020 |
|---|---|---|---|---|
| <65 years | 11.1% | 12.4% | 10.6% | 63.2% |
- TAVR proportion increased in <65 years from 2015 to 2020
- P < 0.001
Observational data: associations, not effects.
Further findings
Charlson comorbidity index (CCI) and in-hospital mortality trends in TAVR patients
- <65 years: CCI unchanged
- P = 0.119 for trend
- <65 years: in-hospital mortality unchanged
- P = 0.740 for trend
- ≥65 years: CCI and in-hospital mortality declined irrespective of sex
- all P < 0.001 for trends
Sex differences (females vs males)
- Females older
- P < 0.001
- Females had lower CCI
- P < 0.001
- Females more likely to undergo TAVR
- P < 0.001
In-hospital mortality, females vs males
- Higher in females after TAVR
- P = 0.015
- Higher in females after SAVR
- P < 0.001
- persisted despite adjustment for age and CCI
Original publication
Association of Age and Sex With Use of Transcatheter Aortic Valve Replacement in France. J Am Coll Cardiol. Published 23 October 2023. doi:10.1016/j.jacc.2023.08.044
Summarised from the published abstract; every number is checked against it