SURTAVI Post Hoc Analysis Compares TAVR and SAVR Outcomes in Men Versus Women

November 24, 2020—Findings from a post hoc analysis of the randomized SURTAVI trial evaluated clinical outcomes of transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) in men and women with aortic stenosis at intermediate operative risk. The international SURTAVI study investigated the safety and efficacy of the CoreValve TAVR system (Medtronic) in the treatment of severe, symptomatic aortic stenosis in intermediate risk patients who need an aortic valve replacement.

The investigators of the post hoc analysis, which sought to identify sex-specific differences in outcomes, concluded that aortic valve replacement, either by surgical or transcatheter approach, appears similarly effective and safe for men and women at intermediate surgical risk. Functional status appears to improve most in women after TAVR.

The findings were presented at the 2020 PCR Valves eCourse, which was held as a virtual conference on November 22-24 and published by Nicolas M. Van Mieghem, MD, et al in EuroIntervention (2020;16:833-841).

As summarized in the EuroIntervention abstract, a total of 1,660 intermediate-risk patients underwent TAVR with a supra-annular, self-expanding bioprosthesis or SAVR. The population was stratified by sex and treatment modality (TAVR: women = 366, men = 498; SAVR: women = 358, men = 438).

The primary endpoint was a composite of all-cause mortality or disabling stroke at 2 years.

The investigators reported the following in EuroIntervention:

• Women compared to men had a smaller body surface area, a higher Society of Thoracic Surgeons score (4.7 ± 1.6% vs 4.3 ± 1.6%; P < .01) and were frailer.
• Men required more concomitant revascularization (23% vs 16%).
• All-cause mortality or disabling stroke at 2 years was similar between TAVR and SAVR for women (10.2% vs 10.5%; P = .90) and men (14.5% vs 14.4%; P = .99).
• The difference between women and men of 2-year all-cause mortality or disabling stroke was 10.2% vs 14.5% for TAVR (P = .08) and 10.5% vs 14.4% for SAVR (P = .13).
• Functional status improvement was more pronounced after TAVR in women than in men.