Outcomes in Patients With Early Menopause Who Underwent Transcatheter Aortic Valve Implantation

Madison Edens, Yusuke Watanabe, Johny Nicolas, Samantha Sartori, Clayton Snyder, Birgit Vogel, Alessandro Spirito, Didier Tchetche, Anna Sonia Petronio, Julinda Mehilli, Thierry Lefèvre, Patrizia Presbitero, Piera Capranzano, Alexandra Selberg, Alessandro Iadanza, Gennaro Sardella, Nicolas M. Van Mieghem, Emanuele Meliga, Nicolas Dumonteil, Chiara FraccaroDaniela Trabattoni, Ghada Mikhail, Maria Cruz Ferrer-Gracia, Christoph Naber, Samin Sharma, Marie Claude Morice, George D. Dangas, Alaide Chieffo, Roxana Mehran

Research output: Contribution to journalArticlepeer-review


Early menopause is associated with an increased risk of cardiovascular diseases, including aortic stenosis (AS). We sought to investigate the prevalence and impact of early menopause on clinical outcomes in patients who underwent transcatheter aortic valve implantation (TAVI) for severe symptomatic AS. Women's International TAVI is a multinational, prospective, observational registry of women who underwent TAVI for severe symptomatic AS (n = 1,019). Patients were divided into 2 groups based on age of menopause: early menopause (age ≤45 years) and regular menopause (age >45 years). The primary outcome of interest was Valve Academic Research Consortium 2 efficacy end point, a composite of mortality, stroke, myocardial infarction, hospitalization for valve-related symptoms, or heart failure or valve-related dysfunction at 1-year follow-up. Of 732 patients with available data on menopause age, 173 (23.6%) were classified as having early menopause. These patients presented for TAVI at a younger age (81.6 ± 6.9 vs 82.7 ± 5.9, p = 0.05) and had a significantly lower Society of Thoracic Surgeons score (6.6 ± 4.8 vs 8.2 ± 7.1, p = 0.03) than those with regular menopause. However, the total valve calcium volume was smaller among patients with early versus regular menopause (731.8 ± 850.9 mm3 vs 807.6 ± 633.8 mm3, p = 0.002). Other co-morbidities were similar between the 2 groups. At 1-year follow-up, there were no significant differences in clinical outcomes between patients with early versus regular menopause (hazard ratio 1.00, 95% confidence interval 0.61 to 1.63, p = 1.00). In conclusion, despite presenting for TAVI at a younger age, patients with early menopause had a similar risk of adverse events as patients with regular menopause at 1 year after TAVI.

Original languageEnglish
Pages (from-to)221-227
Number of pages7
JournalAmerican Journal of Cardiology
StatePublished - 1 Apr 2023


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