Key result
Male gender was associated with a higher likelihood of achieving NYHA class I or II at one year following transcatheter mitral valve repair compared to female gender (OR 1.53), despite worse preoperative comorbidities.
Why the study?
The effect of gender on patients with mitral valve regurgitation undergoing transcatheter mitral valve repair remained to be defined.
Does male gender affect clinical outcomes and mortality in patients with mitral valve regurgitation undergoing transcatheter mitral valve repair compared to female gender?
Meta-Analysis (n=25,736)
Does male gender affect clinical outcomes and mortality in patients with mitral valve regurgitation undergoing transcatheter mitral valve repair compared to female gender?
Odds Ratio: 1.53 (95% CI 1.23–1.91)
Absolute Event Rate: 69.5% vs 59.5%
p-value: p=0.0001
Following transcatheter mitral valve repair, men have worse preoperative comorbidities but achieve superior postoperative NYHA class at one year compared to women, with no significant difference in mortality.
Men achieve better NYHA class but higher AKI risk after TMVR with similar mortality; extends sex-specific outcome data in mitral valve interventions.
BACKGROUND: The effect of gender on patients with mitral valve regurgitation (MR) undergoing transcatheter mitral valve repair (TMVR) remains to be defined. The aim of the present study is a comprehensive meta-analysis of studies that investigate differences between men and women after TMVR. METHODS: A systematic literature search was carried out on eight databases to collect all relevant studies on gender-related outcomes of TMVR before March 1, 2021. The main outcomes of interest were mortality, cardiac function, MR class and other complications. RESULTS: A total of eight literatures were included, all of which were retrospective observational studies. Compared to women patients, men had lower postoperative New York Heart Association (NYHA) class (OR = 1.53, 95%CI [1.23, 1.91], P = 0.0001) and higher incidence of postoperative acute kidney injury (AKI) (OR = 1.25, 95%CI [1.16, 1.34], P < 0.05). There were no significant difference on mortality in 30 days (OR = 0.95, 95%CI [0.81, 1.11], P = 0.53) and in 2 years (OR = 0.99, 95%CI [0.75, 1.30], P = 0.93), mitral valve regurgitation (MR) class (OR = 1.30, 95%CI [0.97, 1.75], P = 0.08) and incidence of myocardial infarction (MI) (OR = 0.88, 95%CI [0.65, 1.18], P = 0.38), stroke (OR = 0.80, 95%CI [0.63, 1.02], P = 0.08) and bleeding in hospital (OR = 0.84, 95%CI [0.59, 1.19], P = 0.32). CONCLUSIONS: Our meta-analysis demonstrates that men undergoing TMVR have worse preoperative diseases (diabetes mellitus, coronary artery disease, renal failure and myocardial infarction) while they have superior postoperative NYHA class at one-year. There are no significantly difference in other indexes between men and women.
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Kang et al. (2023) conducted a meta-analysis in Mitral valve regurgitation (n=25,736). Male gender vs. Female gender was evaluated on Postoperative NYHA ≤ II class at 1 year (OR 1.53, 95% CI 1.23-1.91, p=0.0001). Male gender was associated with a higher likelihood of achieving NYHA class I or II at one year following transcatheter mitral valve repair compared to female gender (OR 1.53), despite worse preoperative comorbidities.
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