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Sex Differences in Infective Endocarditis After Transcatheter Aortic Valve Replacement

Vassili Panagides 1 Mohamed Abdel-Wahab 2 Norman Mangner 2 Eric Durand 3 Nikolaj Ihlemann 4 Marina Urena 5 Costanza Pellegrini 6 Francesco Giannini 7 Piotr Scislo 8 Zenon Huczek 8 Martin Landt Vincent Auffret 9, 10 Jan Malte Sinning 11 Asim Cheema 12 Luis Nombela-Franco 13 Chekrallah Chamandi 14 Francisco Campelo-Parada 15 Erika Munoz-Garcia 16 Howard Herrmann 17 Luca Testa 18 Won-Keun Kim 19 Helene Eltchaninoff 3 Lars Sondergaard 20 Dominique Himbert 5 Oliver Husser 6 Azeem Latib 7, 21 Hervé Le Breton 10, 9 Clement Servoz 15 Philippe Gervais 1 David Del Val 1 Axel Linke 22, 23 Lisa Crusius 23 Holger Thiele 23 David Holzhey 23 Josep Rodés-Cabau 1, * 
Abstract : 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.
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Submitted on : Friday, September 16, 2022 - 10:49:02 AM
Last modification on : Monday, September 19, 2022 - 11:59:39 AM

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Vassili Panagides, Mohamed Abdel-Wahab, Norman Mangner, Eric Durand, Nikolaj Ihlemann, et al.. Sex Differences in Infective Endocarditis After Transcatheter Aortic Valve Replacement. Canadian Journal of Cardiology, Elsevier, 2022, 38 (9), pp.1418-1425. ⟨10.1016/j.cjca.2022.07.002⟩. ⟨hal-03776230⟩

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