Inpatient Outcomes of Tricuspid Transcatheter Edge-to-Edge Repair in the United States Based on Sex

Background: Tricuspid transcatheter edge-to-edge repair (T-TEER) has emerged as an effective and safe option for the repair of tricuspid regurgitation in select patients. Prior studies on invasive and percutaneous cardiac interventions have shown differential outcomes based on sex, but specific studies investigating T-TEER outcomes on a national level are limited. Methods: The National Inpatient Sample and International Classification of Diseases, Tenth Revision codes were used to identify patients who underwent T-TEER in the US from 2018 to 2021. The study group was then stratified based on sex. Study end points assessed included inpatient complications, outcomes, and resource utilization after T-TEER. A multivariable logistic regression model was used to assess the independent association of sex with study outcomes. Results: A total of 1960 T-TEER procedures were identified, of which 1210 occurred in female patients (61.7%). Female patients were older and generally had a lower prevalence of important comorbidities than male patients. In unadjusted analysis, female sex was associated with lower prevalence of major, overall, and cardiovascular complications, inpatient mortality, and length and cost of stay. After multivariable adjustment, female sex was associated with lower inpatient mortality (adjusted odds ratio [aOR], 0.43; 95% CI, 0.22-0.82), lower major complications, (aOR, 0.69; 95% CI, 0.49-0.98), and lower cost of stay (aOR, 0.67; 95% CI, 0.55-0.82). Conclusions: Female sex was associated with similar or better inpatient outcomes and mortality after T-TEER when compared with male sex. Further investigation to understand the etiology behind these important differences is encouraged to promote improved cardiovascular care and outcomes in patients regardless of sex.