Impact of Gender on Mortality After Transcatheter Edge-to-Edge Repair for Functional Mitral Regurgitation.

Recent studies suggested short-term mortality after transcatheter edge-to-edge repair (TEER) was comparable between men and women. However, the gender-specific prognostic difference in the long-term follow-up after TEER is still unknown. To evaluate the impact of gender on long-term mortality after TEER for functional mitral regurgitation (FMR) using multicenter registry data. We retrospectively analyzed 1,233 patients (male 60.3%) who underwent TEER for FMR at 24 centers. The impact of gender on all-cause death and hospitalization for heart failure (HF) after TEER was evaluated using multivariate regression analysis and propensity score (PS) matching methods. During the 2-year follow-up, 207 all-cause death and 263 hospitalizations for HF were observed after TEER for FMR. Men had a significantly higher incidence of all-cause death than women (18.6% vs 14.1%, log-rank p = 0.03). After adjustment by multivariate Cox regression and PS matching, the male gender was significantly associated with a higher incidence of all-cause mortality after TEER than the female gender (hazard ratio 2.11, 95% confidence interval 1.42 to 3.14 in multivariate Cox regression; hazard ratio 1.89, 95% confidence interval 1.03 to 3.48 in PS matching). The gender-specific prognostic difference was even more pronounced after 1-year of TEER. On the contrary, there was no gender-related difference in hospitalization for HF after TEER. In conclusion, women with FMR had a better prognosis after TEER than men, whereas this was not observed in hospitalization for HF. This result might indicate that women with FMR are more likely to benefit from TEER.

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Déclaration de conflit d'intérêts

Declaration of Competing Interest Drs. Hioki and Asami received honoraria for a lecture from Abbott Medical. Drs. Yamamoto, Watanabe, Kataoka, Kubo, Izumo, Mizuno, Nakajima, and Shirai are clinical proctors of transcatheter edge-to-edge repair for Abbott Medical. Dr. Saji is a clinical proctor of transcatheter edge-to-edge repair for Abbott Medical and received a consultant fee from Abbott Medical. Dr. Ohno is the advisor of Abbott Medical and received consultant and speaker fees from Abbott Medical. Dr. Yamaguchi is a clinical proctor of transcatheter edge-to-edge repair for Abbott Medical and received a lecture fee and a scholarship donation from Abbott Medical. The remaining authors have no competing interests to declare.