0298: Influence of gender on mortality and perioperative outcomes in patients undergoing transcatheter aortic valve implantation: insights from the France 2 registry

Aim Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement for high-risk patients. The relative event rates following TAVI have not yet been well described and seem to differ between genders. We sought to determine gender imbalances in TAVI patients with regard to baseline presentation, management, and prognosis. Methods and results A total of 3,972 patients underwent TAVI and were prospectively included in the FRANCE 2 registry. Women (n=1967) presented with older age and lower rates of coronary artery disease, chronic obstructive pulmonary disease, renal failure, and arrhythmia, though higher prevalence of hypertension and congestive heart failure (43.7% vs. 39.7%; p=0.010). EuroSCORE was similar between genders. Women presented with smaller aortic annulus and were implanted with smaller bioprostheses. At 1 month, mortality rates were similar between genders. Multivariate analysis revealed the following independent predictors for 1-month all-cause mortality: female gender; New York Heart Association (NYHA) Class III or IV; transapical approach; moderate to severe postprocedural aortic regurgitation. We observed a specific interaction between gender and EuroSCORE, confirming EuroSCORE as less capable to discriminate women in order to establish 1-month mortality. Women presented with lower 1-year mortality rates than men (19.3% vs. 23.7%; p=0.021). Female gender was an independent predictor of 1-year survival (HR: 0.71, 95% CI: [0.57-0.88]). Conclusion Men and women exhibited several differing baseline characteristics, as well as procedural and clinical outcomes. Notably, Euroscore proved inconvenient for 1-month survival prediction in women. Women also presented with an 18.5% decrease in 1-year all-cause mortality compared to men.