PASCAL M-TEER resulted in similar 1-year mortality for females and males (11.0% vs 12.1%; P=0.266), although females achieved an optimal result less frequently (55.7% vs 65.9%; P<0.001).
Observational (n=2,601)
Yes
Does female sex affect outcomes in patients with mitral regurgitation undergoing PASCAL M-TEER?
PASCAL M-TEER results in similar 1-year mortality across sexes, with residual MR reduction to mild or less being the primary determinant of improved survival.
Absolute Event Rate: 11% vs 12.1%
p-value: p=0.266
BACKGROUND: Mitral valve transcatheter edge-to-edge repair (M-TEER) is an established treatment for patients with mitral regurgitation (MR) at prohibitive surgical risk. Sex-specific M-TEER outcomes are mainly derived from small, historic, MR etiology-specific, or MitraClip-treated cohorts. OBJECTIVES: The objective of the study was to evaluate sex-specific outcomes in patients undergoing PASCAL M-TEER. METHODS: REgistry of PAscal for mItral Regurgitation is an investigator-initiated, multicenter M-TEER registry. Outcomes included Mitral Valve Academic Research Consortium-defined technical success, optimal result at discharge (residual MR ≤ 1+ and mean transmitral pressure gradient <5 mm Hg), and 1-year all-cause mortality. RESULTS: Among 2,601 patients, 1,150 (44.2%) were females and 1,451 (55.8%) were males. MR etiology distribution was similar between sexes (primary: 33.5% vs 32.4%; secondary: 48.9% vs 52.1%; mixed: 17.6% vs 15.6%; P = 0.219). Technical success was achieved in 97.0% vs 97.7% (P = 0.395). An optimal result was achieved more often in males (55.7% vs 65.9%; P < 0.001), driven by higher postprocedural gradients in females (mean transmitral valve pressure gradient ≥5 mm Hg: 24.0% vs 14.0%; P< 0.001), whereas residual mild or less MR was similar (71.3% vs 74.6%; P = 0.066). One-year mortality was 11.0% (95% CI: 8.7%-13.2%) vs 12.1% (95% CI: 10.1%-14.1%; P = 0.266). Residual mild or less MR was independently associated with lower 1-year mortality (adjusted HR: 0.57; 95% CI: 0.38-0.84; P = 0.005), whereas gradients <5 mm Hg were not (adjusted HR: 0.63; 95% CI: 0.40-1.01; P = 0.056). CONCLUSIONS: PASCAL M-TEER resulted in similar technical success rates and 1-year mortality across sexes, despite females achieving an optimal result less frequently, due to higher postprocedural gradients. MR reduction to mild or less was the primary determinant of improved survival, consistent across sexes.
Stein et al. (Fri,) conducted a observational in Mitral regurgitation (n=2,601). PASCAL M-TEER vs. Sex-based comparison (Males vs Females) was evaluated on 1-year all-cause mortality (p=0.266). PASCAL M-TEER resulted in similar 1-year mortality for females and males (11.0% vs 12.1%; P=0.266), although females achieved an optimal result less frequently (55.7% vs 65.9%; P<0.001).