B-64 | Outcomes of Transcatheter Mitral Valve Repair With MitraClip in Hospitalizations With Underlying Thrombocytopenia

Transcatheter mitral valve repair (TMVR) with MitraClip (MC) has emerged as an alternative to surgical repair for high risk patients. We aimed to assess the effect of thrombocytopenia (TCP) on hospitalizations undergoing TMVR with MC. We identified hospitalizations undergoing TMVR with MC and concomitant TCP using their International Classification of Disease - 10 Clinical Modification (ICD-10-CM) codes from the National Inpatient Sample (NIS) Database 2016-2020. We studied primary disease outcomes including mortality, length of stay (LOS) and total hospital charges (THC). Multivariate logistic regression and linear regression analyses were used to adjust for possible confounders. Out of the 38,770 hospitalizations undergoing TMVR with MC, 2,869 (7%) had TCP. Those with concomitant TCP had significantly increased mortality (Adjusted odds ratio (aOR): 2.64, [95% Confidence Interval (CI) 1.75-3.98, p < 0.001], higher THC of $59678 ( 95% CI: 34176-85179, p < 0.001), and longer LOS (coefficient: 2.58, 95% CI 1.64-3.53, p < 0.001). Additionally, those with TCP had higher odds of cardiac arrest (aOR: 2.68, CI: 1.17-6.11, p < 0.012), acute kidney injury (AKI) (aOR: 1.91, CI: 1.54-2.38, p < 0.001), post-operative bleeding (aOR: 3.00, CI: 2.32-3.88, p < 0.001), and blood transfusion (aOR: 2.37, CI: 1.70-3.29, p < 0.001). No significant difference was seen in the development of atrial/ventricular arrhythmias, or ischemic stroke. TCP was evident in 7% of hospitalizations undergoing TMVR with MC. Its presence substantially increased inpatient mortality, THC, and LOS. Moreover, heightened odds of cardiac arrest, AKI, post-operative bleeding, and the requirement for blood transfusion. Given these outcomes, special attention should be directed towards individuals with TCP undergoing TMVR with MC. Further studies are imperative to assess additional safety considerations in this context.