Sex Differences in Acute Ischemic Stroke After Transcatheter Aortic Valve Implantation in Chronic Inflammatory Disease: National Inpatient Study

Sex Differences in Acute Ischemic Stroke After Transcatheter Aortic Valve Implantation in Chronic Inflammatory Disease: National Inpatient Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Sex Differences in Acute Ischemic Stroke After Transcatheter Aortic Valve Implantation in Chronic Inflammatory Disease: National Inpatient Study Qinning Zhang, Ru Yan, Guangzhi Cong, Shaobin Jia This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8194187/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Chronic inflammatory diseases (CID) increase the risk of aortic stenosis, but sex-specific outcomes after transcatheter aortic valve implantation (TAVI) in this population are unclear. Using the US National Inpatient Sample (2016–2021), we identified adults with CID undergoing TAVI and classified CID as inflammatory arthritis, systemic autoimmune, or organ-specific inflammatory disease. Primary outcomes were acute ischemic stroke (AIS) and in-hospital mortality. Multivariable logistic regression adjusted for demographics and comorbidities, with stratified analyses by CID subtype. Among 15,825 patients, 9,695 (61.3%) were female. Compared with males, females were less often White (87.2% vs 92.1%) and had fewer cardiovascular risk factors, including dyslipidemia (65.5% vs 75.0%), diabetes (28.9% vs 34.3%), prior coronary artery bypass grafting (4.3% vs 15.7%), and smoking (29.6% vs 51.2%). After adjustment, females had a significantly lower risk of AIS (1.3% vs 2.4%; adjusted odds ratio [aOR] 0.50, 95% confidence interval [CI] 0.29–0.88), while in-hospital mortality was similar (1.0% vs 0.7%; aOR 0.96, 95% CI 0.41–2.22). The lower AIS risk in females was most pronounced in the inflammatory arthritis subgroup (aOR 0.34, 95% CI 0.14–0.81). Females with CID undergoing TAVI have lower AIS risk but comparable in-hospital mortality versus males, particularly in inflammatory arthritis patients. Health sciences/Cardiology Health sciences/Diseases Health sciences/Medical research Health sciences/Rheumatology Health sciences/Risk factors Transcatheter Aortic Valve Implantation Chronic Inflammatory Diseases Sex Differences Acute Ischemic Stroke Inflammatory Arthritis Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementalMaterial.pdf Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 12 Apr, 2026 Reviewers invited by journal 06 Apr, 2026 Editor assigned by journal 23 Dec, 2025 Editor invited by journal 09 Dec, 2025 Submission checks completed at journal 05 Dec, 2025 First submitted to journal 28 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8194187","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":621679750,"identity":"28fc0065-8799-46fd-901d-708205d3d5b8","order_by":0,"name":"Qinning Zhang","email":"","orcid":"","institution":"The First Clinical College of Ningxia Medical University, General Hospital of Ningxia Medical University","correspondingAuthor":false,"prefix":"","firstName":"Qinning","middleName":"","lastName":"Zhang","suffix":""},{"id":621679751,"identity":"59f50603-f032-4d01-a6c4-5d19df21397f","order_by":1,"name":"Ru 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Implantation, Chronic Inflammatory Diseases, Sex Differences, Acute Ischemic Stroke, Inflammatory Arthritis","lastPublishedDoi":"10.21203/rs.3.rs-8194187/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8194187/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"Chronic inflammatory diseases (CID) increase the risk of aortic stenosis, but sex-specific outcomes after transcatheter aortic valve implantation (TAVI) in this population are unclear. Using the US National Inpatient Sample (2016–2021), we identified adults with CID undergoing TAVI and classified CID as inflammatory arthritis, systemic autoimmune, or organ-specific inflammatory disease. Primary outcomes were acute ischemic stroke (AIS) and in-hospital mortality. Multivariable logistic regression adjusted for demographics and comorbidities, with stratified analyses by CID subtype. Among 15,825 patients, 9,695 (61.3%) were female. Compared with males, females were less often White (87.2% vs 92.1%) and had fewer cardiovascular risk factors, including dyslipidemia (65.5% vs 75.0%), diabetes (28.9% vs 34.3%), prior coronary artery bypass grafting (4.3% vs 15.7%), and smoking (29.6% vs 51.2%). After adjustment, females had a significantly lower risk of AIS (1.3% vs 2.4%; adjusted odds ratio [aOR] 0.50, 95% confidence interval [CI] 0.29–0.88), while in-hospital mortality was similar (1.0% vs 0.7%; aOR 0.96, 95% CI 0.41–2.22). The lower AIS risk in females was most pronounced in the inflammatory arthritis subgroup (aOR 0.34, 95% CI 0.14–0.81). Females with CID undergoing TAVI have lower AIS risk but comparable in-hospital mortality versus males, particularly in inflammatory arthritis patients.","manuscriptTitle":"Sex Differences in Acute Ischemic Stroke After Transcatheter Aortic Valve Implantation in Chronic Inflammatory Disease: National Inpatient Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-13 12:57:14","doi":"10.21203/rs.3.rs-8194187/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"335659913958444094423580801290944559257","date":"2026-04-12T12:16:21+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-07T03:08:14+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-23T08:31:36+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-09T13:37:20+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-05T10:06:59+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-11-28T16:16:35+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"894f8021-83c0-495d-a292-b84cc04856cb","owner":[],"postedDate":"April 13th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":66156399,"name":"Health sciences/Cardiology"},{"id":66156400,"name":"Health sciences/Diseases"},{"id":66156401,"name":"Health sciences/Medical research"},{"id":66156402,"name":"Health sciences/Rheumatology"},{"id":66156403,"name":"Health sciences/Risk factors"}],"tags":[],"updatedAt":"2026-04-13T12:57:14+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-13 12:57:14","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8194187","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8194187","identity":"rs-8194187","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}