Sex-Based Differences in Outcomes With Percutaneous Transcatheter Repair of Mitral Regurgitation With the MitraClip System: Transcatheter Valve Therapy Registry From 2011 to 2017.


Journal

Circulation. Cardiovascular interventions
ISSN: 1941-7632
Titre abrégé: Circ Cardiovasc Interv
Pays: United States
ID NLM: 101499602

Informations de publication

Date de publication:
11 2021
Historique:
entrez: 16 11 2021
pubmed: 17 11 2021
medline: 23 11 2021
Statut: ppublish

Résumé

Women have a higher rate of adverse events after mitral valve surgery. We sought to evaluate whether outcomes after transcatheter edge-to-edge repair intervention by sex have similar trends to mitral valve surgery. The primary outcome was 1-year major adverse events defined as a composite of all-cause mortality, stroke, and any bleeding in the overall study cohort. Patients who underwent transcatheter edge-to-edge repair for mitral regurgitation with the MitraClip system in the Society of Thoracic Surgery/American College of Cardiology Transcatheter Valve Therapy registry were evaluated. Linked administrative claims from the Centers for Medicare and Medicaid Services were used to evaluate 1-year clinical outcomes. Associations between sex and outcomes were evaluated using a multivariable logistic regression model for in-hospital outcomes and Cox model for 1-year outcomes. From November 2013 to March 2017, 5295 patients, 47.6% (n=2523) of whom were female, underwent transcatheter edge-to-edge repair. Females were less likely to have >1 clip implanted ( No difference in composite outcome of all-cause mortality, stroke, and any bleeding was observed between females and males. Adjusted 1-year all-cause mortality was lower in females compared with males.

Sections du résumé

BACKGROUND
Women have a higher rate of adverse events after mitral valve surgery. We sought to evaluate whether outcomes after transcatheter edge-to-edge repair intervention by sex have similar trends to mitral valve surgery.
METHODS
The primary outcome was 1-year major adverse events defined as a composite of all-cause mortality, stroke, and any bleeding in the overall study cohort. Patients who underwent transcatheter edge-to-edge repair for mitral regurgitation with the MitraClip system in the Society of Thoracic Surgery/American College of Cardiology Transcatheter Valve Therapy registry were evaluated. Linked administrative claims from the Centers for Medicare and Medicaid Services were used to evaluate 1-year clinical outcomes. Associations between sex and outcomes were evaluated using a multivariable logistic regression model for in-hospital outcomes and Cox model for 1-year outcomes.
RESULTS
From November 2013 to March 2017, 5295 patients, 47.6% (n=2523) of whom were female, underwent transcatheter edge-to-edge repair. Females were less likely to have >1 clip implanted (
CONCLUSIONS
No difference in composite outcome of all-cause mortality, stroke, and any bleeding was observed between females and males. Adjusted 1-year all-cause mortality was lower in females compared with males.

Identifiants

pubmed: 34784236
doi: 10.1161/CIRCINTERVENTIONS.120.009374
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

e009374

Commentaires et corrections

Type : CommentIn

Auteurs

Pedro A Villablanca (PA)

Department of Medicine, Division of Cardiology, Center for Structural Heart Disease, Henry Ford Hospital, Detroit, MI (P.A.V., C.-y.S., M.H.E., D.D.W., T.M.F., J.C.L., G.K., A.L., W.W.O.).

Sreekanth Vemulapalli (S)

Duke Clinical Research Institute, Durham, NC (S.V., A.S., D.D.).

Amanda Stebbins (A)

Duke Clinical Research Institute, Durham, NC (S.V., A.S., D.D.).

Dadi Dai (D)

Duke Clinical Research Institute, Durham, NC (S.V., A.S., D.D.).

Chak-Yu So (CY)

Department of Medicine, Division of Cardiology, Center for Structural Heart Disease, Henry Ford Hospital, Detroit, MI (P.A.V., C.-y.S., M.H.E., D.D.W., T.M.F., J.C.L., G.K., A.L., W.W.O.).

Marvin H Eng (MH)

Department of Medicine, Division of Cardiology, Center for Structural Heart Disease, Henry Ford Hospital, Detroit, MI (P.A.V., C.-y.S., M.H.E., D.D.W., T.M.F., J.C.L., G.K., A.L., W.W.O.).

Dee Dee Wang (DD)

Department of Medicine, Division of Cardiology, Center for Structural Heart Disease, Henry Ford Hospital, Detroit, MI (P.A.V., C.-y.S., M.H.E., D.D.W., T.M.F., J.C.L., G.K., A.L., W.W.O.).

Tiberio M Frisoli (TM)

Department of Medicine, Division of Cardiology, Center for Structural Heart Disease, Henry Ford Hospital, Detroit, MI (P.A.V., C.-y.S., M.H.E., D.D.W., T.M.F., J.C.L., G.K., A.L., W.W.O.).

James C Lee (JC)

Department of Medicine, Division of Cardiology, Center for Structural Heart Disease, Henry Ford Hospital, Detroit, MI (P.A.V., C.-y.S., M.H.E., D.D.W., T.M.F., J.C.L., G.K., A.L., W.W.O.).

Guson Kang (G)

Department of Medicine, Division of Cardiology, Center for Structural Heart Disease, Henry Ford Hospital, Detroit, MI (P.A.V., C.-y.S., M.H.E., D.D.W., T.M.F., J.C.L., G.K., A.L., W.W.O.).

Molly Szerlip (M)

Baylor Scott and White Health, Plano, TX (M.S.).

Homam Ibrahim (H)

Division of Cardiology, NYU Grossman School of Medicine (H.I., C.S., M.R.W., B.S.).

Cezar Staniloae (C)

Division of Cardiology, NYU Grossman School of Medicine (H.I., C.S., M.R.W., B.S.).

Prakriti Gaba (P)

Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, NY (P.G., M.F., M.B.L.).

Alejandro Lemor (A)

Department of Medicine, Division of Cardiology, Center for Structural Heart Disease, Henry Ford Hospital, Detroit, MI (P.A.V., C.-y.S., M.H.E., D.D.W., T.M.F., J.C.L., G.K., A.L., W.W.O.).

Matthew Finn (M)

Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, NY (P.G., M.F., M.B.L.).

Harish Ramakrishna (H)

Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN (H.R.).

Mathew R Williams (MR)

Division of Cardiology, NYU Grossman School of Medicine (H.I., C.S., M.R.W., B.S.).

Martin B Leon (MB)

Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, NY (P.G., M.F., M.B.L.).
Cardiovascular Research Foundation, New York, NY (M.B.L.).

William W O'Neill (WW)

Department of Medicine, Division of Cardiology, Center for Structural Heart Disease, Henry Ford Hospital, Detroit, MI (P.A.V., C.-y.S., M.H.E., D.D.W., T.M.F., J.C.L., G.K., A.L., W.W.O.).

Binita Shah (B)

Division of Cardiology, NYU Grossman School of Medicine (H.I., C.S., M.R.W., B.S.).
Division of Cardiology, VA New York Harbor Healthcare System (B.S.).

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