Abstract 4145445: Sex Differences in Time from Referral to Procedure, Functional Capacity, and Quality of Life Improvement After Transcatheter Aortic Valve Replacement

Background: Transcatheter aortic valve replacement (TAVR) has been shown to improve survival and quality of life (QOL). The Kansas City Cardiomyopathy Questionnaire (KCCQ) monitors four domains of valvular heart disease (physical limitation, symptom frequency, social limitation, and QOL) before and after TAVR, yielding an overall summary score (KCCQ-OS). Prior studies have acknowledged sex-based discrepancies in baseline health status prior to TAVR, such as older age and fewer cardiovascular comorbidities among females. However, time from initial referral to procedure date may contribute to sex-based differences in KCCQ-OS before and after TAVR. Methods: We compared differences between pre-procedure and post-procedure KCCQ-OS, assessed at 30-day and 1-year follow-up in 649 patients (353 males and 296 females) who underwent TAVR at Santa Barbara Cottage Hospital between 2015 and 2024. We also examined differences in baseline patient characteristics including age, co-morbidities, and time to procedure from initial referral date. Results: Females were older and had a higher prevalence of hypertension compared to males (80.1% vs 78.8%) but lower prevalence of all other traditional cardiovascular comorbidities. Females had significantly lower baseline KCCQ-OS compared to males (56.17 ± 26.01 vs 61.58 ± 26.09, p = 0.003) (Figure 1). Compared to baseline scores, all patients had significant increases in their scores at post-TAVR 30-day and 1-year follow-up (p < 0.001) (Figure 1). At both 30-day and 1-year follow up, males had higher KCCQ-OS compared to females [(87.37 ± 16.55 vs 84.24 ± 16.91, p = 0.009), (87.87 ± 16.61 vs 85.42 ± 17.82, p = 0.04)] (Figure 1). Time to TAVR (days) from initial referral was significantly higher not only in patients under the age of 80 (p = 0.01) but also in females compared to males (p = 0.02) (Figure 1). Conclusion: Females consistently had lower KCCQ-OS at baseline and post-TAVR, indicating measurements of lower functional capacity and quality of life compared to males. Despite fewer comorbidities at baseline, the impact of delays from referral to procedure data among females may contribute to lower KCCQ-OS before and after TAVR.