IMPULSE: the impact of gender on the presentation and management of aortic stenosis across Europe
Aims There is an increasing awareness of gender-related differences in patients with severe aortic stenosis and their outcomes after surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI).Methods Data from the IMPULSE registry were analysed. Patients with severe...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2021-02-01
|
| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/8/1/e001443.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850193703037042688 |
|---|---|
| author | Peter Bramlage Norbert Frey Matthias Lutz Richard Paul Steeds Berto J Bouma Jana Kurucova Martin Thoenes David Messika-Zeitoun Cornelia Deutsch Tanja K Rudolph Jeetendra Thambyrajah Antonio Serra Eberhard Schulz Jiri Maly Marco Aiello Alessandro Santo Bortone Alberto Clerici Johannes Rieber Massimo Mancone Loic Belle Alexander Lauten Martin Arnold Georg Delle-Karth |
| author_facet | Peter Bramlage Norbert Frey Matthias Lutz Richard Paul Steeds Berto J Bouma Jana Kurucova Martin Thoenes David Messika-Zeitoun Cornelia Deutsch Tanja K Rudolph Jeetendra Thambyrajah Antonio Serra Eberhard Schulz Jiri Maly Marco Aiello Alessandro Santo Bortone Alberto Clerici Johannes Rieber Massimo Mancone Loic Belle Alexander Lauten Martin Arnold Georg Delle-Karth |
| author_sort | Peter Bramlage |
| collection | DOAJ |
| description | Aims There is an increasing awareness of gender-related differences in patients with severe aortic stenosis and their outcomes after surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI).Methods Data from the IMPULSE registry were analysed. Patients with severe aortic stenosis (AS) were enrolled between March 2015 and April 2017 and stratified by gender. A subgroup analysis was performed to assess the impact of age.Results Overall, 2171 patients were enrolled, and 48.0% were female. Women were characterised by a higher rate of renal impairment (31.7 vs 23.3%; p<0.001), were at higher surgical risk (EuroSCORE II: 4.5 vs 3.6%; p=0.001) and more often in a critical preoperative state (7.0vs 4.2%; p=0.003). Men had an increased rate of previous cardiac surgery (9.4 vs 4.7%; p<0.001) and a reduced left ventricular ejection fraction (4.9 vs 1.3%; p<0.001). Concomitant mitral and tricuspid valve disease was substantially more common among women. Symptoms were highly prevalent in both women and men (83.6 vs 77.3%; p<0.001). AVR was planned in 1379 cases. Women were more frequently scheduled to undergo TAVI (49.3 vs 41.0%; p<0.001) and less frequently for SAVR (20.3 vs 27.5%; p<0.001).Conclusions The present data show that female patients with severe AS have a distinct patient profile and are managed in a different way to males. Gender-based differences in the management of patients with severe AS need to be taken into account more systematically to improve outcomes, especially for women. |
| format | Article |
| id | doaj-art-840d406aca7e43d39bb5d6661693eaac |
| institution | OA Journals |
| issn | 2053-3624 |
| language | English |
| publishDate | 2021-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-840d406aca7e43d39bb5d6661693eaac2025-08-20T02:14:11ZengBMJ Publishing GroupOpen Heart2053-36242021-02-018110.1136/openhrt-2020-001443IMPULSE: the impact of gender on the presentation and management of aortic stenosis across EuropePeter Bramlage0Norbert Frey1Matthias Lutz2Richard Paul Steeds3Berto J Bouma4Jana Kurucova5Martin Thoenes6David Messika-Zeitoun7Cornelia Deutsch8Tanja K Rudolph9Jeetendra Thambyrajah10Antonio Serra11Eberhard Schulz12Jiri Maly13Marco Aiello14Alessandro Santo Bortone15Alberto Clerici16Johannes Rieber17Massimo Mancone18Loic Belle19Alexander Lauten20Martin Arnold21Georg Delle-Karth22Institut für Pharmakologie und Präventive Medizin GmbH, Cloppenburg, GermanyDepartment of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Heidelberg, GermanyDepartment of Cardiology and Angiology, University of Kiel, Kiel, GermanyInstitute of Cardiovascular Sciences, University of Birmingham, Birmingham, UKDepartment of Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The NetherlandsMedical Affairs, Edwards Lifesciences, Prague, Czech RepublicMedical Affairs, Edwards Lifesciences, Nyon, SwitzerlandUniversity of Ottawa Heart Institute, Ottawa, Ontario, CanadaInstitute for Pharmacology and Preventive Medicine, Cloppenburg, GermanyDepartment of Cardiology, Hear and Diabetes Center Bad Oeynhausen, Ruhr-University of Bochum, Bad Oeynhausen, GermanyJames Cook University Hospital, Middlesbrough, UKInterventional Cardiology Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalunya, SpainCardiology Department, AKH Celle, Celle, Niedersachsen, GermanyDepartment of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech RepublicDepartment of Cardiothoracic Surgery, Foundation IRCCS Policlinico S.Matteo, Pavia, ItalyUniversity of Bari, Bari, Puglia, ItalyUniversity of Turin, Turin, Piemonte, ItalyHerzkatheterlabor Nymphenburg and Department of Cardiology, University of Munich, Munich, Bayern, GermanySapienza University of Rome, Rome, ItalyCentre Hospital d’Annecy, Annecy, FranceDepartment for Cardiology, Helios Clinic, Erfurt, GermanyDepartment of Cardiology, University Hospital Erlangen, Erlangen, Bayern, GermanyKarl Landsteiner Institute for Cardiovascular and Critical Care Research, Vienna, AustriaAims There is an increasing awareness of gender-related differences in patients with severe aortic stenosis and their outcomes after surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI).Methods Data from the IMPULSE registry were analysed. Patients with severe aortic stenosis (AS) were enrolled between March 2015 and April 2017 and stratified by gender. A subgroup analysis was performed to assess the impact of age.Results Overall, 2171 patients were enrolled, and 48.0% were female. Women were characterised by a higher rate of renal impairment (31.7 vs 23.3%; p<0.001), were at higher surgical risk (EuroSCORE II: 4.5 vs 3.6%; p=0.001) and more often in a critical preoperative state (7.0vs 4.2%; p=0.003). Men had an increased rate of previous cardiac surgery (9.4 vs 4.7%; p<0.001) and a reduced left ventricular ejection fraction (4.9 vs 1.3%; p<0.001). Concomitant mitral and tricuspid valve disease was substantially more common among women. Symptoms were highly prevalent in both women and men (83.6 vs 77.3%; p<0.001). AVR was planned in 1379 cases. Women were more frequently scheduled to undergo TAVI (49.3 vs 41.0%; p<0.001) and less frequently for SAVR (20.3 vs 27.5%; p<0.001).Conclusions The present data show that female patients with severe AS have a distinct patient profile and are managed in a different way to males. Gender-based differences in the management of patients with severe AS need to be taken into account more systematically to improve outcomes, especially for women.https://openheart.bmj.com/content/8/1/e001443.full |
| spellingShingle | Peter Bramlage Norbert Frey Matthias Lutz Richard Paul Steeds Berto J Bouma Jana Kurucova Martin Thoenes David Messika-Zeitoun Cornelia Deutsch Tanja K Rudolph Jeetendra Thambyrajah Antonio Serra Eberhard Schulz Jiri Maly Marco Aiello Alessandro Santo Bortone Alberto Clerici Johannes Rieber Massimo Mancone Loic Belle Alexander Lauten Martin Arnold Georg Delle-Karth IMPULSE: the impact of gender on the presentation and management of aortic stenosis across Europe Open Heart |
| title | IMPULSE: the impact of gender on the presentation and management of aortic stenosis across Europe |
| title_full | IMPULSE: the impact of gender on the presentation and management of aortic stenosis across Europe |
| title_fullStr | IMPULSE: the impact of gender on the presentation and management of aortic stenosis across Europe |
| title_full_unstemmed | IMPULSE: the impact of gender on the presentation and management of aortic stenosis across Europe |
| title_short | IMPULSE: the impact of gender on the presentation and management of aortic stenosis across Europe |
| title_sort | impulse the impact of gender on the presentation and management of aortic stenosis across europe |
| url | https://openheart.bmj.com/content/8/1/e001443.full |
| work_keys_str_mv | AT peterbramlage impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT norbertfrey impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT matthiaslutz impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT richardpaulsteeds impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT bertojbouma impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT janakurucova impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT martinthoenes impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT davidmessikazeitoun impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT corneliadeutsch impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT tanjakrudolph impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT jeetendrathambyrajah impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT antonioserra impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT eberhardschulz impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT jirimaly impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT marcoaiello impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT alessandrosantobortone impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT albertoclerici impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT johannesrieber impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT massimomancone impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT loicbelle impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT alexanderlauten impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT martinarnold impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope AT georgdellekarth impulsetheimpactofgenderonthepresentationandmanagementofaorticstenosisacrosseurope |