Valvular & structural heart diseaseMeta-analysis
Sex-Specific and Time-Dependent Outcomes After Transcatheter Aortic Valve Replacement (TAVR) Versus Surgical Aortic Valve Replacement (SAVR)
- Meta-Analysis of Randomized Controlled Trials
- random-effects models
- prespecified analyses by sex and surgical risk
- exploratory meta-regression
Authors' conclusion
Outcomes after aortic valve replacement vary by sex, surgical risk, and time. TAVR was associated with early benefit in women, particularly in intermediate-high-risk patients, with convergence over longer follow-up, whereas men showed no significant differences across time points, with higher risk observed with TAVR at 5 years in intermediate-high-risk patients. (Sex Differences in Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement: An Updated Meta-Analysis of Randomized Controlled Trials; CRD420261287967).
Study context
- Population
- Randomized controlled trials of TAVR vs SAVR reporting sex-stratified, mortality-inclusive primary endpoints with ≥1-year follow-upNine trials, 44.2% women
- Participants
- 9,583 participants
- Comparison
- TAVR vs SAVR, by sex, time and surgical risk
Pooled result
As reported in the abstract
Further pooled results
Mortality-inclusive primary endpoint, men
- In men, no significant differences were observed across time points
By surgical risk
- Early benefit with TAVR in women more evident in intermediate-high-risk patients
- At 5 years a higher risk with TAVR was observed in men
- No clear sex differences in low-risk patients
Meta-regression
- No significant effect modification by age, surgical risk, or atrial fibrillation prevalence
- exploratory
Original publication
Summarised from the published abstract; every number is checked against it