Sex Differences in Infective Endocarditis After Transcatheter Aortic Valve Replacement

Vassili Panagides; Mohamed Abdel-Wahab; Norman Mangner; Eric Durand; Nikolaj Ihlemann; Marina Urena; Costanza Pellegrini; Francesco Giannini; Piotr Scislo; Zenon Huczek; Martin Landt; Vincent Auffret; Jan Malte Sinning; Asim N. Cheema; Luis Nombela-Franco; Chekrallah Chamandi; Francisco Campelo-Parada; Erika Munoz-Garcia; Howard C. Herrmann; Luca Testa; Won Keun Kim; Helene Eltchaninoff; Lars Sondergaard; Dominique Himbert; Oliver Husser; Azeem Latib; Hervé le Breton; Clement Servoz; Philippe Gervais; David del Val; Axel Linke; Lisa Crusius; Holger Thiele; David Holzhey; Josep Rodés-Cabau

doi:10.1016/j.cjca.2022.07.002

Sex Differences in Infective Endocarditis After Transcatheter Aortic Valve Replacement

Vassili Panagides
, Mohamed Abdel-Wahab
, Norman Mangner
, Eric Durand
, Nikolaj Ihlemann
, Marina Urena
, Costanza Pellegrini
, Francesco Giannini
, Piotr Scislo
, Zenon Huczek
, Martin Landt
, Vincent Auffret
, Jan Malte Sinning
, Asim N. Cheema
, Luis Nombela-Franco
, Chekrallah Chamandi
, Francisco Campelo-Parada
, Erika Munoz-Garcia
, Howard C. Herrmann
, Luca Testa

Won Keun Kim, Helene Eltchaninoff, Lars Sondergaard, Dominique Himbert, Oliver Husser, Azeem Latib, Hervé le Breton, Clement Servoz, Philippe Gervais, David del Val, Axel Linke, Lisa Crusius, Holger Thiele, David Holzhey, Josep Rodés-Cabau^*

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Abstract

Background: Outcomes after transcatheter aortic valve replacement (TAVR) and infectious diseases may vary according to sex. Methods: This multicentre study aimed to determine the sex differences in clinical characteristics, management, and outcomes of infective endocarditis (IE) after TAVR. A total of 579 patients (217 women, 37.5%) who had the diagnosis of definite IE following TAVR were included retrospectively from the Infectious Endocarditis After TAVR International Registry. Results: Women were older (80 ± 8 vs 78 ± 8 years; P = 0.001) and exhibited a lower comorbidity burden. Clinical characteristics and microbiological profiles were similar between men and women, but culture-negative IE was more frequent in women (9.9% vs 4.3%; P = 0.009). A high proportion of patients had a clinical indication for surgery (54.4% in both groups; P = 0.99), but a surgical intervention was performed in a minority of patients (women 15.2%, men 20.3%; P = 0.13). The mortality rate at index IE hospitalisation was similar in both groups (women 35.4%, men 31.7%; P = 0.37), but women exhibited a higher mortality rate at 2-year follow-up (63% vs 52.1%; P = 0.021). Female sex remained an independent risk factor for cumulative mortality in the multivariable analysis (adjusted HR 1.28, 95% CI 1.02-1.62; P = 0.035). After adjustment for in-hospital events, surgery was not associated with better outcomes in women. Conclusions: There were no significant sex-related differences in the clinical characteristics and management of IE after TAVR. However, female sex was associated with increased 2-year mortality risk.

Originalsprog	Engelsk
Tidsskrift	Canadian Journal of Cardiology
Vol/bind	38
Udgave nummer	9
Sider (fra-til)	1418-1425
ISSN	0828-282X
DOI	https://doi.org/10.1016/j.cjca.2022.07.002
Status	Udgivet - 2022

Bibliografisk note

Publisher Copyright:
© 2022 Canadian Cardiovascular Society

Finansiering

We acknowledge the Infectious Endocarditis After TAVR International Registry Investigators for their substantial contribution to data collection and research (the list of investigators is available in Supplemental Appendix S1). Dr Panagides has received a research grant from the “Mediterranean Academic Research and Studies in Cardiology” association. Dr Rodés-Cabau holds the Research Chair “Fondation Famille Jacques Larivière” for the development of structural heart disease interventions. The authors have no funding sources to declare. Dr Panagides has received institutional research grants from Medtronic, Boston Scientific, and Microport. Dr Mangner reports personal fees from Edwards Lifesciences, Medtronic, Biotronik, Novartis, Sanofi Genzyme, AstraZeneca, Pfizer, and Bayer, outside the submitted work. Dr Sinning reports speaker honouraria from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic and research grants from Boston Scientific, Edwards Lifesciences, and Medtronic, outside the submitted work. Dr Herrmann has received institutional research grants from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic and consulting fees from Edwards Lifesciences and Medtronic. Dr Kim reports personal fees from Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, and Meril, outside the submitted work. Dr Sondergaard has received consultant fees and/or institutional research grants from Abbott, Boston Scientific, Medtronic and SMT. Dr Husser reports personal fees from Boston Scientific and payments from Abbott. Dr Rodés-Cabau has received institutional research grants from Edwards Lifesciences, Medtronic, and Boston Scientific, and speaker fees from Edwards Lifesciences, Medtronic. The other authors have no conflicts of interest to disclose.

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Citationsformater

Panagides, V., Abdel-Wahab, M., Mangner, N., Durand, E., Ihlemann, N., Urena, M., Pellegrini, C., Giannini, F., Scislo, P., Huczek, Z., Landt, M., Auffret, V., Sinning, J. M., Cheema, A. N., Nombela-Franco, L., Chamandi, C., Campelo-Parada, F., Munoz-Garcia, E., Herrmann, H. C., ... Rodés-Cabau, J. (2022). Sex Differences in Infective Endocarditis After Transcatheter Aortic Valve Replacement. Canadian Journal of Cardiology, 38(9), 1418-1425. https://doi.org/10.1016/j.cjca.2022.07.002

Panagides, V, Abdel-Wahab, M, Mangner, N, Durand, E, Ihlemann, N, Urena, M, Pellegrini, C, Giannini, F, Scislo, P, Huczek, Z, Landt, M, Auffret, V, Sinning, JM, Cheema, AN, Nombela-Franco, L, Chamandi, C, Campelo-Parada, F, Munoz-Garcia, E, Herrmann, HC, Testa, L, Kim, WK, Eltchaninoff, H, Sondergaard, L, Himbert, D, Husser, O, Latib, A, le Breton, H, Servoz, C, Gervais, P, del Val, D, Linke, A, Crusius, L, Thiele, H, Holzhey, D & Rodés-Cabau, J 2022, 'Sex Differences in Infective Endocarditis After Transcatheter Aortic Valve Replacement', Canadian Journal of Cardiology, bind 38, nr. 9, s. 1418-1425. https://doi.org/10.1016/j.cjca.2022.07.002

@article{e3bf44aaba7d47f08e08cc0d42c1fb73,

title = "Sex Differences in Infective Endocarditis After Transcatheter Aortic Valve Replacement",

abstract = "Background: Outcomes after transcatheter aortic valve replacement (TAVR) and infectious diseases may vary according to sex. Methods: This multicentre study aimed to determine the sex differences in clinical characteristics, management, and outcomes of infective endocarditis (IE) after TAVR. A total of 579 patients (217 women, 37.5\%) who had the diagnosis of definite IE following TAVR were included retrospectively from the Infectious Endocarditis After TAVR International Registry. Results: Women were older (80 ± 8 vs 78 ± 8 years; P = 0.001) and exhibited a lower comorbidity burden. Clinical characteristics and microbiological profiles were similar between men and women, but culture-negative IE was more frequent in women (9.9\% vs 4.3\%; P = 0.009). A high proportion of patients had a clinical indication for surgery (54.4\% in both groups; P = 0.99), but a surgical intervention was performed in a minority of patients (women 15.2\%, men 20.3\%; P = 0.13). The mortality rate at index IE hospitalisation was similar in both groups (women 35.4\%, men 31.7\%; P = 0.37), but women exhibited a higher mortality rate at 2-year follow-up (63\% vs 52.1\%; P = 0.021). Female sex remained an independent risk factor for cumulative mortality in the multivariable analysis (adjusted HR 1.28, 95\% CI 1.02-1.62; P = 0.035). After adjustment for in-hospital events, surgery was not associated with better outcomes in women. Conclusions: There were no significant sex-related differences in the clinical characteristics and management of IE after TAVR. However, female sex was associated with increased 2-year mortality risk.",

author = "Vassili Panagides and Mohamed Abdel-Wahab and Norman Mangner and Eric Durand and Nikolaj Ihlemann and Marina Urena and Costanza Pellegrini and Francesco Giannini and Piotr Scislo and Zenon Huczek and Martin Landt and Vincent Auffret and Sinning, \{Jan Malte\} and Cheema, \{Asim N.\} and Luis Nombela-Franco and Chekrallah Chamandi and Francisco Campelo-Parada and Erika Munoz-Garcia and Herrmann, \{Howard C.\} and Luca Testa and Kim, \{Won Keun\} and Helene Eltchaninoff and Lars Sondergaard and Dominique Himbert and Oliver Husser and Azeem Latib and \{le Breton\}, Herv{\'e} and Clement Servoz and Philippe Gervais and \{del Val\}, David and Axel Linke and Lisa Crusius and Holger Thiele and David Holzhey and Josep Rod{\'e}s-Cabau",

note = "Funding Information: We acknowledge the Infectious Endocarditis After TAVR International Registry Investigators for their substantial contribution to data collection and research (the list of investigators is available in Supplemental Appendix S1). Dr Panagides has received a research grant from the “Mediterranean Academic Research and Studies in Cardiology” association. Dr Rod{\'e}s-Cabau holds the Research Chair “Fondation Famille Jacques Larivi{\`e}re” for the development of structural heart disease interventions. The authors have no funding sources to declare. Dr Panagides has received institutional research grants from Medtronic, Boston Scientific, and Microport. Dr Mangner reports personal fees from Edwards Lifesciences, Medtronic, Biotronik, Novartis, Sanofi Genzyme, AstraZeneca, Pfizer, and Bayer, outside the submitted work. Dr Sinning reports speaker honouraria from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic and research grants from Boston Scientific, Edwards Lifesciences, and Medtronic, outside the submitted work. Dr Herrmann has received institutional research grants from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic and consulting fees from Edwards Lifesciences and Medtronic. Dr Kim reports personal fees from Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, and Meril, outside the submitted work. Dr Sondergaard has received consultant fees and/or institutional research grants from Abbott, Boston Scientific, Medtronic and SMT. Dr Husser reports personal fees from Boston Scientific and payments from Abbott. Dr Rod{\'e}s-Cabau has received institutional research grants from Edwards Lifesciences, Medtronic, and Boston Scientific, and speaker fees from Edwards Lifesciences, Medtronic. The other authors have no conflicts of interest to disclose. ",

year = "2022",

doi = "10.1016/j.cjca.2022.07.002",

language = "English",

volume = "38",

pages = "1418--1425",

journal = "Canadian Journal of Cardiology",

issn = "0828-282X",

publisher = "Elsevier",

number = "9",

}

TY - JOUR

T1 - Sex Differences in Infective Endocarditis After Transcatheter Aortic Valve Replacement

AU - Panagides, Vassili

AU - Abdel-Wahab, Mohamed

AU - Mangner, Norman

AU - Durand, Eric

AU - Ihlemann, Nikolaj

AU - Urena, Marina

AU - Pellegrini, Costanza

AU - Giannini, Francesco

AU - Scislo, Piotr

AU - Huczek, Zenon

AU - Landt, Martin

AU - Auffret, Vincent

AU - Sinning, Jan Malte

AU - Cheema, Asim N.

AU - Nombela-Franco, Luis

AU - Chamandi, Chekrallah

AU - Campelo-Parada, Francisco

AU - Munoz-Garcia, Erika

AU - Herrmann, Howard C.

AU - Testa, Luca

AU - Kim, Won Keun

AU - Eltchaninoff, Helene

AU - Sondergaard, Lars

AU - Himbert, Dominique

AU - Husser, Oliver

AU - Latib, Azeem

AU - le Breton, Hervé

AU - Servoz, Clement

AU - Gervais, Philippe

AU - del Val, David

AU - Linke, Axel

AU - Crusius, Lisa

AU - Thiele, Holger

AU - Holzhey, David

AU - Rodés-Cabau, Josep

N1 - Funding Information: We acknowledge the Infectious Endocarditis After TAVR International Registry Investigators for their substantial contribution to data collection and research (the list of investigators is available in Supplemental Appendix S1). Dr Panagides has received a research grant from the “Mediterranean Academic Research and Studies in Cardiology” association. Dr Rodés-Cabau holds the Research Chair “Fondation Famille Jacques Larivière” for the development of structural heart disease interventions. The authors have no funding sources to declare. Dr Panagides has received institutional research grants from Medtronic, Boston Scientific, and Microport. Dr Mangner reports personal fees from Edwards Lifesciences, Medtronic, Biotronik, Novartis, Sanofi Genzyme, AstraZeneca, Pfizer, and Bayer, outside the submitted work. Dr Sinning reports speaker honouraria from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic and research grants from Boston Scientific, Edwards Lifesciences, and Medtronic, outside the submitted work. Dr Herrmann has received institutional research grants from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic and consulting fees from Edwards Lifesciences and Medtronic. Dr Kim reports personal fees from Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, and Meril, outside the submitted work. Dr Sondergaard has received consultant fees and/or institutional research grants from Abbott, Boston Scientific, Medtronic and SMT. Dr Husser reports personal fees from Boston Scientific and payments from Abbott. Dr Rodés-Cabau has received institutional research grants from Edwards Lifesciences, Medtronic, and Boston Scientific, and speaker fees from Edwards Lifesciences, Medtronic. The other authors have no conflicts of interest to disclose.

PY - 2022

Y1 - 2022

N2 - Background: Outcomes after transcatheter aortic valve replacement (TAVR) and infectious diseases may vary according to sex. Methods: This multicentre study aimed to determine the sex differences in clinical characteristics, management, and outcomes of infective endocarditis (IE) after TAVR. A total of 579 patients (217 women, 37.5%) who had the diagnosis of definite IE following TAVR were included retrospectively from the Infectious Endocarditis After TAVR International Registry. Results: Women were older (80 ± 8 vs 78 ± 8 years; P = 0.001) and exhibited a lower comorbidity burden. Clinical characteristics and microbiological profiles were similar between men and women, but culture-negative IE was more frequent in women (9.9% vs 4.3%; P = 0.009). A high proportion of patients had a clinical indication for surgery (54.4% in both groups; P = 0.99), but a surgical intervention was performed in a minority of patients (women 15.2%, men 20.3%; P = 0.13). The mortality rate at index IE hospitalisation was similar in both groups (women 35.4%, men 31.7%; P = 0.37), but women exhibited a higher mortality rate at 2-year follow-up (63% vs 52.1%; P = 0.021). Female sex remained an independent risk factor for cumulative mortality in the multivariable analysis (adjusted HR 1.28, 95% CI 1.02-1.62; P = 0.035). After adjustment for in-hospital events, surgery was not associated with better outcomes in women. Conclusions: There were no significant sex-related differences in the clinical characteristics and management of IE after TAVR. However, female sex was associated with increased 2-year mortality risk.

AB - Background: Outcomes after transcatheter aortic valve replacement (TAVR) and infectious diseases may vary according to sex. Methods: This multicentre study aimed to determine the sex differences in clinical characteristics, management, and outcomes of infective endocarditis (IE) after TAVR. A total of 579 patients (217 women, 37.5%) who had the diagnosis of definite IE following TAVR were included retrospectively from the Infectious Endocarditis After TAVR International Registry. Results: Women were older (80 ± 8 vs 78 ± 8 years; P = 0.001) and exhibited a lower comorbidity burden. Clinical characteristics and microbiological profiles were similar between men and women, but culture-negative IE was more frequent in women (9.9% vs 4.3%; P = 0.009). A high proportion of patients had a clinical indication for surgery (54.4% in both groups; P = 0.99), but a surgical intervention was performed in a minority of patients (women 15.2%, men 20.3%; P = 0.13). The mortality rate at index IE hospitalisation was similar in both groups (women 35.4%, men 31.7%; P = 0.37), but women exhibited a higher mortality rate at 2-year follow-up (63% vs 52.1%; P = 0.021). Female sex remained an independent risk factor for cumulative mortality in the multivariable analysis (adjusted HR 1.28, 95% CI 1.02-1.62; P = 0.035). After adjustment for in-hospital events, surgery was not associated with better outcomes in women. Conclusions: There were no significant sex-related differences in the clinical characteristics and management of IE after TAVR. However, female sex was associated with increased 2-year mortality risk.

U2 - 10.1016/j.cjca.2022.07.002

DO - 10.1016/j.cjca.2022.07.002

M3 - Journal article

C2 - 35842172

AN - SCOPUS:85137390223

SN - 0828-282X

VL - 38

SP - 1418

EP - 1425

JO - Canadian Journal of Cardiology

JF - Canadian Journal of Cardiology

IS - 9

ER -