ABACUS Repository

Institutional repository of the Universidad Europea where the scientific production of its research community is collected. The purpose of the repository is to provide access and visibility to this work by gathering, preserving and disseminating this production.

 

Recent Submissions

Thumbnail Image
Item
Sex differences in surgically treated left-sided infective endocarditis: Results from the international, prospective, multicenter BESOS study
(2026-09-09) Tomasino, Marco; Fernández Hidalgo, Núria; Issa, Nahema; Ternacle, Julien; Kosovan, Dmytro; Joean, Oana; Bertolino, Lorenzo; Fiore, Antonio; Padalino, Massimo A.; Ferreira González, Ignacio; Et al.
Objectives: We aimed to describe sex differences in clinical characteristics and 30-day mortality in a large contemporary cohort of patients undergoing surgery for left-sided infective endocarditis (IE). Methods: The international Barcelona Endocarditis Surgery Outcome Score registry included consec utive patients undergoing surgery for active left-sided IE across 55 centres in 19 countries in 2025. Clinical characteristics and outcomes were prospectively collected. The primary outcome was 30-day mortality. Propensity score 1:1 nearest-neighbour matching (PSM) was performed to generate anced male and female cohorts. Cox proportional hazards models were used to assess the association between sex and mortality, with adjustment for age, comorbidities and frailty, IE characteristics, and preoperative severity. Results: Among 1085 patients undergoing surgery for left-sided IE (median age 65 years, interquartile range 53—73), 239 (22%) were women. Men and women had a similar burden of cardiovascular risk factors and comorbidities, although women exhibited greater frailty (Clinical Frailty Scale ≥7: 22/236 [9%] vs. 36/826 [4%]; p 0.01). Women more frequently presented with isolated mitral valve involvement (116/238 [49%] vs. 238/845 [29%]) and staphylococcal aetiology (86/239 [36%] vs. 218/846 [26%]; p 0.03). PSM identified 225 balanced male-female pairs. Thirty-day mortality was higher in women than in men in both the overall cohort (49/239 [21%] vs. 87/846 [10%]; p <0.01) and the matched cohort (45/225 [20%] vs. 28/225 [12%]; p 0.02). Female sex remained associated with increased 30-day tality after adjustment (hazard ratio, 1.58; 95% interval [CI], 1.02—2.45; p 0.04). Conclusions: In this large contemporary multinational cohort of patients undergoing surgery for left- sided IE, female sex was independently associated with higher 30-day mortality. The persistence of this association after PSM and multivariable adjustment suggests that the excess risk in women is not fully explained by differences in baseline characteristics, disease presentation, or preoperative severity, highlighting the need to better understand sex-related disparities in surgical IE outcomes.
Thumbnail Image
Item
Sex differences in preoperative cardiac damage in patients with primary mitral regurgitation: impact on surgical outcomes
(2026-09-08) Barriales, Lucía; Islas, Fabían; Carnero, Manuel; Landín, Patricia; García Onrubia, Jorge; Pérez Camargo, Daniel; Montero, Lourdes; Rivadeneira, María; Gil Abizanda, Sandra; Olmos Blanco, Carmen; Et al.
Introduction and objectives Prior evidence suggests that women have worse outcomes after surgery for mitral regurgitation (MR). We aimed to examine sex-related differences in preoperative cardiac damage among patients with severe primary MR and to assess the impact of these differences on surgical outcomes. Methods We performed a retrospective analysis of a prospective cohort of patients undergoing surgery for primary MR at a tertiary hospital (2014-2022). Baseline clinical and echocardiographic data and 1-year outcomes (all-cause mortality and heart failure [HF] hospitalizations) were compared by sex. Results A total of 349 patients were included; 154 (44%) were female. Women were older, had a higher comorbidity burden and were more frequently symptomatic at the time of surgery. Compared with men, women had significantly more advanced (right-sided) cardiac damage before surgery (54.5% vs 36.5%; P = .017), greater impairment of left ventricular global longitudinal strain and left atrial reservoir strain, and worse right ventricular-pulmonary arterial coupling. Mitral valve repair was more common in men, whereas women more often required concomitant tricuspid valve repair. At 1 year, the incidence of HF hospitalizations was higher in women (7% vs 1%; HR, 2.41; 95%CI, 1.14-6.30), and there was a nonsignificant trend toward higher all-cause mortality (11% vs 6.2%; HR, 1.72; 95%CI, 0.79-3.76). Conclusions Women with primary MR were more often symptomatic at the time of surgery, presented with more advanced biventricular and left atrial dysfunction preoperatively, and had higher HF hospitalization rates after surgery. New strategies are needed to ensure equitable management and outcomes between sexes.

We participate