Publication: Differences in life expectancy between men and women after aortic valve replacement
Authors
Hernández Vaquero, Daniel ; Rodríguez Caulo, Emiliano ; Vigil Escalera, Carlota ; Blanco Herrera, Oscar ; Berastegui, Elisabet ; Arias Dachary, Javier ; Souaf, Souhayla ; Parody, Gertrudis ; Laguna, Gregorio ; Adsuar, Alejandro ; Castellá, Manuel ; Valderrama, José F. ; Pulitani, Ivana ; Cánovas López, Sergio ; Ferreiro, Andrea ; García Valentín, Antonio ; Carnero, Manuel ; Pareja, Pilar ; Corrales, José A. ; Blázquez, José A. ; Macías, Diego ; Fletcher-Sanfeliu, Delfina ; Martínez, Daniel ; Martín, Elio ; Martín, Miren ; Margarit, Juan ; Hernández Estefanía, Rafael ; Monguió, Emilio ; Otero, Juan ; Silva, Jacobo
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Publisher
Oxford University Press
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DOI
https://doi.org/10.1093/ejcts/ezab140
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info:eu-repo/semantics/article
Description
© The Author(s) 2021.This document is the Published version of a Published Work that appeared in final form in European Journal of Cardio-Thoracic Surgery. To access the final edited and published work see https://doi.org/10.1093/ejcts/ezab140
Abstract
OBJECTIVES: Some researchers have observed an increased number of deaths during the follow-up of young patients who undergo aortic valve replacement due to severe aortic stenosis, suggesting that this procedure does not restore their life expectancy. Our goal was to confirm these findings and explore sex-based differences. METHODS: All patients between 50 and 65 years of age who underwent isolated aortic valve replacement in 27 Spanish centres during an 18-year period were included. We compared observed and expected survival at 15 years of follow-up and estimated the cumulative incidence of death from a competing risks point of view. We stratified by sex and analysed if being a woman was an independent risk factor for death. RESULTS: For men, the observed survival at 10 and 15 years of follow-up was 85% [95% confidence interval (CI) 83.6%–86.4%] and 72.3% (95% CI 69.7%–74.7%), respectively whereas the expected survival was 88.1% and 78.8%. For women, the observed survival at 10 and 15 years was 85% (95% CI 82.8%–86.9%) and 73% (95% CI 69.1%–76.4%), whereas the expected survival was 94.6% and 89.4%. At 15 years of follow-up, the cumulative incidence of death due to the disease in men and women was 8.2% and 16.7%, respectively. In addition, being a woman was an independent risk factor for death (hazard ratio = 1.23 (95% CI 1.02–1.48; P = 0.03). CONCLUSIONS: After the aortic valve replacement, men and women do not have their life expectancy restored, but this loss is much higher in women than in men. In addition, being a woman is a risk factor for long-term death. Reasons for these findings are unknown and must be investigated.
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Citation
European Journal of Cardio-Thoracic Surgery 60 (2021) 681–688
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