Sex based differences between pre-intervention outcomes in patients with severe aortic stenosis - a real world study

Abstract Introduction Transcatheter aortic valve implantation (TAVI) is the preferred treatment for severe aortic stenosis (SAS) in older pts. However, due to limited availability, many pts face prolonged waiting times. Despite similar incidences between sexes, underlying pathophysiological mechanisms may differ. Identifying sex-related differences in pre-procedural outcomes may improve risk stratification, influence procedural aspects and enhance patient prognosis. Objectives We sought to characterize and compare pre-procedural outcomes between male and female pts with SAS awaiting TAVI. Methods Single-center retrospective cohort study of SAS pts who consecutively underwent pre-TAVI cardiac computed tomography (CCT) protocol between June 2022 and September 2024. Demographic and clinical data, transthoracic echocardiography (TTE), coronary angiography and CCT parameters were collected. The pre-procedural endpoint was a composite of cardiovascular (CV) hospitalization, all-cause mortality, and major adverse cardiovascular events (MACE), consisting of CV mortality, non-fatal acute myocardial infarction and stroke, whichever occurred first. Male (group A) and female (group B) pts were compared using SPSS v29. Results A total of 189 pts (mean age 81.2 ± 5 years) underwent pre-TAVI CCT during the study period and were divided in two groups - 98 males (group A) and 91 females (group B). No significant differences were observed between groups in terms of demographic or clinical characteristics (table 1), except for smoking, history of percutaneous coronary intervention and obstructive coronary artery (CAD) disease which were more frequent among male pts (21.4% vs. 1.1%, p