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Peer-reviewedCC BY 4.0Frontiers in Cardiovascular Medicine

Sex differences in clinical outcomes after transcatheter aortic valve implantation: a real-world cohort

  • Miriam Estévez Táboas1
  • Julio Echarte-Morales1,2,3
  • Ernesto José Ruiz Golcher4
  • Carlos Eduardo Sotomayor-Casillas5
  • André González García1
  • David Neuhalfen1
  • Carla Iglesias-Otero1
  • Elena García-Campos Losada1
  • Nazaret Vázquez-Vázquez1
  • David González Fernández1
  • Hugo Prado Prado1
  • Carmen Cuiñas Fariña1
6 more authors
  • Andrés Antelo-Abeijón1
  • Pablo Juan-Salvadores1,2
  • Rodrigo Estevez-Loureiro1,2,3
  • Jose A. Baz Alonso1,2,3
  • Andres Iñiguez-Romo1,2,3
  • Victor Alfonso Jímenez-Díaz1,2,3
5 affiliations
  1. 1Cardiology, Hospital Alvaro Cunqueiro
  2. 2Cardiovascular Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur)
  3. 3Interventional Cardiology Clinic, University Hospital Alvaro Cunqueiro
  4. 4Servicio de Cardiología, Hospital Rafael Ángel Calderón Guardia
  5. 5Cardiología. Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud
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Abstract

Background: Severe aortic stenosis is one of the most prevalent valvular heart diseases in the ageing population, and transcatheter aortic valve implantation (TAVI) has become an effective and less invasive therapeutic alternative. Anatomical, pathophysiological, and clinical differences between women and men may influence outcomes following the procedure. This study aimed to evaluate the association between sex and mortality and procedure-related complications after TAVI in a real-world cohort from the Vigo Health Area.

Methods: We conducted a retrospective, single-center observational study including 1,065 patients with severe aortic stenosis who underwent transfemoral TAVI between 2010 and 2023. The primary endpoint was all-cause mortality at 1 year. Secondary endpoints included bleeding, vascular complications, and new permanent pacemaker implantation. Time-to-event analyses were censored at 365 days; multivariable models used complete-case analysis.

Results: Women were older and had greater frailty and higher surgical risk scores than men. In-hospital and 1-year mortality were similar between sexes. Date-based 30-day mortality was 2.4% in men and 3.7% in women ( p = 0.225), and female sex was not independently associated with 30-day mortality after adjustment for age and STS score (adjusted OR 1.79, 95% CI 0.80–3.98; p = 0.154). Female sex was not independently associated with 1-year mortality (adjusted HR 1.07, 95% CI 0.69–1.66; p = 0.772). Women had more bleeding in unadjusted analyses, but female sex was not significantly associated with any bleeding after adjustment (adjusted OR 1.61, 95% CI 0.92–2.81; p = 0.093). Male sex remained associated with higher odds of new permanent pacemaker implantation (adjusted OR 1.49, 95% CI 1.03–2.17; p = 0.036).

Conclusions: Sex was not independently associated with short- or 1-year mortality after TAVI. Women had a higher unadjusted incidence of bleeding, whereas men had a higher incidence of new permanent pacemaker implantation that persisted after adjustment. These findings describe sex-related differences in procedural risk profiles but should be interpreted in the context of the observational design and the long study period.

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Cite

BibTeXRIS
BibTeX
@article{taboas2026differences,
  title = {{Sex differences in clinical outcomes after transcatheter aortic valve implantation: a real-world cohort}},
  author = {Miriam Estévez Táboas and Julio Echarte-Morales and Ernesto José Ruiz Golcher and Carlos Eduardo Sotomayor-Casillas and André González García and David Neuhalfen and Carla Iglesias-Otero and Elena García-Campos Losada and Nazaret Vázquez-Vázquez and David González Fernández and Hugo Prado Prado and Carmen Cuiñas Fariña and Andrés Antelo-Abeijón and Pablo Juan-Salvadores and Rodrigo Estevez-Loureiro and Jose A. Baz Alonso and Andres Iñiguez-Romo and Victor Alfonso Jímenez-Díaz},
  journal = {Frontiers in Cardiovascular Medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fcvm.2026.1941651},
  url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1941651/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Sex differences in clinical outcomes after transcatheter aortic valve implantation: a real-world cohort
AU  - Miriam Estévez Táboas
AU  - Julio Echarte-Morales
AU  - Ernesto José Ruiz Golcher
AU  - Carlos Eduardo Sotomayor-Casillas
AU  - André González García
AU  - David Neuhalfen
AU  - Carla Iglesias-Otero
AU  - Elena García-Campos Losada
AU  - Nazaret Vázquez-Vázquez
AU  - David González Fernández
AU  - Hugo Prado Prado
AU  - Carmen Cuiñas Fariña
AU  - Andrés Antelo-Abeijón
AU  - Pablo Juan-Salvadores
AU  - Rodrigo Estevez-Loureiro
AU  - Jose A. Baz Alonso
AU  - Andres Iñiguez-Romo
AU  - Victor Alfonso Jímenez-Díaz
PY  - 2026
DA  - 2026/10/20
JO  - Frontiers in Cardiovascular Medicine
DO  - 10.3389/fcvm.2026.1941651
UR  - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1941651/full
AB  - Background: Severe aortic stenosis is one of the most prevalent valvular heart diseases in the ageing population, and transcatheter aortic valve implantation (TAVI) has become an effective and less invasive therapeutic alternative. Anatomical, pathophysiological, and clinical differences between women and men may influence outcomes following the procedure. This study aimed to evaluate the association between sex and mortality and procedure-related complications after TAVI in a real-world cohort from the Vigo Health Area.  Methods: We conducted a retrospective, single-center observational study including 1,065 patients with severe aortic stenosis who underwent transfemoral TAVI between 2010 and 2023. The primary endpoint was all-cause mortality at 1 year. Secondary endpoints included bleeding, vascular complications, and new permanent pacemaker implantation. Time-to-event analyses were censored at 365 days; multivariable models used complete-case analysis.  Results: Women were older and had greater frailty and higher surgical risk scores than men. In-hospital and 1-year mortality were similar between sexes. Date-based 30-day mortality was 2.4% in men and 3.7% in women ( p = 0.225), and female sex was not independently associated with 30-day mortality after adjustment for age and STS score (adjusted OR 1.79, 95% CI 0.80–3.98; p = 0.154). Female sex was not independently associated with 1-year mortality (adjusted HR 1.07, 95% CI 0.69–1.66; p = 0.772). Women had more bleeding in unadjusted analyses, but female sex was not significantly associated with any bleeding after adjustment (adjusted OR 1.61, 95% CI 0.92–2.81; p = 0.093). Male sex remained associated with higher odds of new permanent pacemaker implantation (adjusted OR 1.49, 95% CI 1.03–2.17; p = 0.036).  Conclusions: Sex was not independently associated with short- or 1-year mortality after TAVI. Women had a higher unadjusted incidence of bleeding, whereas men had a higher incidence of new permanent pacemaker implantation that persisted after adjustment. These findings describe sex-related differences in procedural risk profiles but should be interpreted in the context of the observational design and the long study period.
SN  - 2297-055X
ER  -