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Volume 13
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10.3390/diseases13070191
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Article

Sex Differences in Newly Diagnosed Severe Aortic Stenosis in British Columbia (B.C.)

by
Aishwarya Roshan
1,2,
Jeffrey Yim
2,3,
Shamikh Lakhani
1,
Jennifer Wang
1,
Aamiya Sidhu
1,
Eric C. Sayre
3,
Karin Humphries
3,
Janarthanan Sathananthan
3,
David Wood
3,
Michael Y. C. Tsang
2,3,
Darwin F. Yeung
2,3,
Christina Luong
2,3,
Parvathy Nair
2,3,
Kenneth Gin
2,3,
John Jue
2,3,
John G. Webb
3 and
Teresa S. M. Tsang
2,3,*
1
Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
2
Vancouver General Hospital Artificial Intelligence Echocardiography Core Laboratory, Vancouver, BC V5Z 1M9, Canada
3
Division of Cardiology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
*
Author to whom correspondence should be addressed.
Diseases 2025, 13(7), 191; https://doi.org/10.3390/diseases13070191
Submission received: 11 April 2025 / Revised: 29 May 2025 / Accepted: 20 June 2025 / Published: 22 June 2025
(This article belongs to the Section Cardiology)
Versions Notes

Abstract

Background: Despite its high prevalence, little is known about the effect of sex on the management and outcomes of aortic stenosis (AS). We sought to characterize the effect of sex on the clinical evaluation for and provision of aortic valve replacement (AVR), including surgical (SAVR) and transcatheter aortic valve replacement (TAVR), and the subsequent morbidity and mortality outcomes. Methods: A comprehensive chart review was conducted on all patients with a first diagnosis of severe aortic stenosis (AS) at Vancouver General and University of British Columbia hospitals from 2012 to 2022. Exact chi-square and Kruskal–Wallis tests were used to evaluate the variables of interest. Results: A total of 1794 studies met the inclusion criteria, comprising 782 females (44%) and 1012 males (56%). Females were significantly older than males at the time of the first diagnosis (79 versus 75 years, p < 0.001). Females were significantly less likely to be evaluated by the TAVR clinic or cardiac surgeon or to receive aortic valve intervention (p-value ≤ 0.001). Females were significantly more likely to be rejected for TAVR due to older age (OR 0.23 (0.07, 0.59)), comorbid conditions (OR 0.68 (0.47, 0.97)), and frailty (OR 0.23 (0.07, 0.59)). Females were significantly more likely to be rejected for SAVR on the basis of frailty (OR 0.66 (0.46, 0.94)). Females also had significantly higher rates of 1-year mortality, hospitalization, and heart failure hospitalization compared to males (p-values < 0.05). Conclusions: Our data suggest significant sex-based discrepancies in the management of AS. Females with severe AS are diagnosed later in life and are less likely to be evaluated for valve intervention. They are less likely to receive intervention due to older age, frailty, and multimorbid conditions. Further research is warranted for a more effective identification and follow up of aortic stenosis, as well as timely referral for AVR, where appropriate, especially for females.
Keywords: sex differences; aortic stenosis; transcatheter aortic valve replacement; cardiac surgery; cardiac outcomes sex differences; aortic stenosis; transcatheter aortic valve replacement; cardiac surgery; cardiac outcomes

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MDPI and ACS Style

Roshan, A.; Yim, J.; Lakhani, S.; Wang, J.; Sidhu, A.; Sayre, E.C.; Humphries, K.; Sathananthan, J.; Wood, D.; Tsang, M.Y.C.; et al. Sex Differences in Newly Diagnosed Severe Aortic Stenosis in British Columbia (B.C.). Diseases 2025, 13, 191. https://doi.org/10.3390/diseases13070191

AMA Style

Roshan A, Yim J, Lakhani S, Wang J, Sidhu A, Sayre EC, Humphries K, Sathananthan J, Wood D, Tsang MYC, et al. Sex Differences in Newly Diagnosed Severe Aortic Stenosis in British Columbia (B.C.). Diseases. 2025; 13(7):191. https://doi.org/10.3390/diseases13070191

Chicago/Turabian Style

Roshan, Aishwarya, Jeffrey Yim, Shamikh Lakhani, Jennifer Wang, Aamiya Sidhu, Eric C. Sayre, Karin Humphries, Janarthanan Sathananthan, David Wood, Michael Y. C. Tsang, and et al. 2025. "Sex Differences in Newly Diagnosed Severe Aortic Stenosis in British Columbia (B.C.)" Diseases 13, no. 7: 191. https://doi.org/10.3390/diseases13070191

APA Style

Roshan, A., Yim, J., Lakhani, S., Wang, J., Sidhu, A., Sayre, E. C., Humphries, K., Sathananthan, J., Wood, D., Tsang, M. Y. C., Yeung, D. F., Luong, C., Nair, P., Gin, K., Jue, J., Webb, J. G., & Tsang, T. S. M. (2025). Sex Differences in Newly Diagnosed Severe Aortic Stenosis in British Columbia (B.C.). Diseases, 13(7), 191. https://doi.org/10.3390/diseases13070191

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