AI Article Synopsis

  • - The study aims to investigate whether the differences between men and women in the use of aortic valve replacement (AVR) procedures are changing over time, utilizing data from hospitalizations in Spain from 2016 to 2021.
  • - Out of 64,384 hospitalizations for aortic stenosis, men were more likely to receive surgical AVR, while women received more transcatheter AVR procedures, though overall, men had higher rates of both types of AVR.
  • - By 2020, transcatheter AVR (TAVR) surpassed surgical AVR (SAVR) in prevalence in Spain, with women adopting TAVR earlier despite receiving fewer procedures overall compared to men.

Article Abstract

Background And Aims: It is not well known if sex differences in the use and results of aortic valve replacement (AVR) are changing. The aim of the study is to assess the time trends in the differences by sex in the utilisation of AVR procedures in hospitals and in the community.

Methods: Retrospective observational analysis using data from the Spanish National Hospitalizations Administrative Database. All hospitalisations between 2016 and 2021 with a main diagnosis of aortic stenosis (ICD-10 codes: I35.0 and I35.2) were included. Time trends in hospitalisation, AVRs and hospital outcomes were analysed. Crude utilisation and population-standardised rates were calculated.

Results: During the study period, 64 384 hospitalisations in 55 983 patients (55.5% men) with 36 915 (65,9%) AVR were recorded. Of these, 15 563 (42.2%) were transcatheter and 21 432 (58.0%) surgical. At hospital level, transcatheter procedures were more frequently performed in women (32.3% vs 24.2%, p < 0.001) and surgical in men (42.9% vs. 32.5%, p < 0.001) but at the population level, surgical and transcatheter aortic valve replacements were used more frequently in men (12.6 surgical and 8.0 transcatheter per 100 000 population) vs women (6.4 and 5.8, respectively; p < 0.001 for both comparisons). Transcatheter procedures shifted from 17.3% in 2016 to 38.0% in 2021, overtaking surgical procedures in 2018 for women and 2021 for men.

Conclusions: TAVR has displaced SAVR as the most frequent AVR procedure in Spain by 2020. This occurred earlier in women, who despite the greater weight of their age group in the older population, receive fewer AVRs, both SAVR and TAVR.

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Source
http://dx.doi.org/10.1093/ehjqcco/qcae012DOI Listing

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