{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T03:11:42Z","timestamp":1787973102707,"version":"build-2784847793"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,5,20]]},"abstract":"<jats:sec id=\"jah310963-sec-0001\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Referral for valve intervention for severe aortic stenosis (AS) may exhibit sex\u2010associated disparities independent of the growth of transcatheter interventions. This study aimed to determine whether there were sex\u2010associated differences in the use of aortic valve replacement (AVR), either surgical or transcatheter, in patients with aortic stenosis and severe features from a national cohort of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"jah310963-sec-0002\" xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Using the National Readmission Database, all patients with an index diagnosis of AS between January 2015 and December 2019 were included and stratified by their 90\u2010day readmission status and sex. AS with severe features was defined as the combination of primary\u2010 or secondary\u2010coded diagnosis of AS in combination with heart failure, syncope, angina pectoris, cardiac arrest, or cardiogenic shock. A 1:1 nested case\u2013control matching was performed to account for competing risk. The main investigated outcome was the sex\u2010associated rate of AVR in the 90\u2009days after index hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"jah310963-sec-0003\" xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      A total of 31\u2009712 matched weighted discharges were included in the analysis, 16\u2009597 men (52.3%) and 15\u2009116 women (47.7%). At 90\u2009days, the rate of AVR was significantly lower in women (45.7% versus 53.6%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) with significant difference for both surgical (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) and transcatheter (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.010) interventions. After multivariable adjustment, these differences persisted with women significantly less likely to receive AVR (adjusted odds ratio [aOR], 0.67 [95% CI, 0.63\u20130.71],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), either surgical AVR (aOR, 0.48 [95% CI, 0.43\u20130.54],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) or transcatheter aortic valve implantation (aOR, 0.79 [95% CI, 0.75\u20130.84],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"jah310963-sec-0004\" xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">The use of surgical AVR and transcatheter aortic valve implantation was significantly lower in female patients with AS and severe features independent from patient\u2010 and hospital\u2010level characteristics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.038463","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T05:41:43Z","timestamp":1747287703000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Sex\u2010Associated Disparities in Surgical and Percutaneous Management of Aortic Stenosis With Severe Features: Retrospective Analysis From the National Readmission Database"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5625-3176","authenticated-orcid":false,"given":"Gianluca","family":"Castaldi","sequence":"first","affiliation":[{"name":"University Hospital Leuven","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9272-6906","authenticated-orcid":false,"given":"Andrija","family":"Mateti\u0107","sequence":"additional","affiliation":[{"name":"University Hospital of Split","place":["Croatia"]},{"name":"Royal Stoke University Hospital","place":["Stoke\u2010on\u2010Trent, UK"]},{"name":"Keele University","place":["Stoke\u2010on\u2010Trent, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1888-9429","authenticated-orcid":false,"given":"Rodrigo","family":"Bagur","sequence":"additional","affiliation":[{"name":"Western University","place":["London, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2560-0155","authenticated-orcid":false,"given":"J. D.","family":"Abbott","sequence":"additional","affiliation":[{"name":"Warren Alpert Medical School of Brown UniversityLifespan Cardiovascular Institute","place":["Providence, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8714-0334","authenticated-orcid":false,"given":"Mirvat","family":"Alasnag","sequence":"additional","affiliation":[{"name":"King Fahd Armed Forces Hospital","place":["Jeddah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3505-9112","authenticated-orcid":false,"given":"Alaide","family":"Chieffo","sequence":"additional","affiliation":[{"name":"San Raffaele Scientific Institute","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8464-1080","authenticated-orcid":false,"given":"Harindra C.","family":"Wijeysundera","sequence":"additional","affiliation":[{"name":"University of Toronto","place":["Canada"]},{"name":"University of Toronto","place":["Canada"]},{"name":"University of Toronto","place":["Canada"]},{"name":"Birmingham Biomedical Research Centre","place":["Birmingham, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9241-8890","authenticated-orcid":false,"given":"Mamas A.","family":"Mamas","sequence":"additional","affiliation":[{"name":"Royal Stoke University Hospital","place":["Stoke\u2010on\u2010Trent, UK"]},{"name":"Keele University","place":["Stoke\u2010on\u2010Trent, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-021-00570-z"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.015"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2019.05.044"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz568"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab395"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000932"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2021.01.021"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.006370"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.121.319914"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjqcco\/qcab012"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.1013739"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.23736\/S0021-9509.23.12729-7"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.025944"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.09.034"},{"key":"e_1_3_1_16_2","unstructured":"HCUP . Overview of the Nationwide Readmissions Database (NRD). https:\/\/www.hcup\u2010us.ahrq.gov\/nrdoverview.jsp."},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3299"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-5-5"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.10.028"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1103510"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.01.036"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.05.047"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2021.03.005"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)01202-X"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(99)00106-2"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.09.011"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2019.11.010"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.12442"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.16928"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0184038"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2020-001443"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.02.057"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2020.02.034"},{"key":"e_1_3_1_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.018816"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.15420\/ecr.2022.26"},{"key":"e_1_3_1_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab242"},{"key":"e_1_3_1_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.04.091"},{"key":"e_1_3_1_38_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1436"},{"key":"e_1_3_1_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.02.046"},{"key":"e_1_3_1_40_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.119.010356"},{"key":"e_1_3_1_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2022.06.022"},{"key":"e_1_3_1_42_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2021.3718"},{"key":"e_1_3_1_43_2","doi-asserted-by":"publisher","DOI":"10.26599\/1671-5411.2023.01.003"},{"key":"e_1_3_1_44_2","doi-asserted-by":"publisher","DOI":"10.15420\/ecr.2016:32:1"},{"key":"e_1_3_1_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogn.2016.02.002"},{"key":"e_1_3_1_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2005.08.006"},{"key":"e_1_3_1_47_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1800097115"},{"key":"e_1_3_1_48_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.7875"},{"key":"e_1_3_1_49_2","doi-asserted-by":"publisher","DOI":"10.15420\/ecr.2022.33"},{"key":"e_1_3_1_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjco.2021.07.012"},{"key":"e_1_3_1_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2020.06.001"},{"key":"e_1_3_1_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2021.106779"},{"key":"e_1_3_1_53_2","doi-asserted-by":"publisher","DOI":"10.15420\/ecr.2022.23"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.124.038463","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T08:04:55Z","timestamp":1747728295000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.124.038463"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,20]]},"references-count":52,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,5,20]]}},"alternative-id":["10.1161\/JAHA.124.038463"],"URL":"https:\/\/doi.org\/10.1161\/jaha.124.038463","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,20]]},"assertion":[{"value":"2024-08-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e038463"}}