Female sex was associated with a lower 1-year risk of all-cause mortality (HR 0.80; 95% CI 0.68-0.94) compared with males after MitraClip repair, with no difference in the primary composite outcome.
Cohort
Yes
Does female sex affect 1-year major adverse events in patients undergoing transcatheter edge-to-edge repair for mitral regurgitation?
In patients undergoing transcatheter edge-to-edge repair for mitral regurgitation, females had similar 1-year composite adverse events but lower 1-year all-cause mortality compared to males, despite lower initial device success.
BACKGROUND: Women have a higher rate of adverse events after mitral valve surgery. We sought to evaluate whether outcomes after transcatheter edge-to-edge repair intervention by sex have similar trends to mitral valve surgery. METHODS: The primary outcome was 1-year major adverse events defined as a composite of all-cause mortality, stroke, and any bleeding in the overall study cohort. Patients who underwent transcatheter edge-to-edge repair for mitral regurgitation with the MitraClip system in the Society of Thoracic Surgery/American College of Cardiology Transcatheter Valve Therapy registry were evaluated. Linked administrative claims from the Centers for Medicare and Medicaid Services were used to evaluate 1-year clinical outcomes. Associations between sex and outcomes were evaluated using a multivariable logistic regression model for in-hospital outcomes and Cox model for 1-year outcomes. RESULTS: <0.001) and had a lower adjusted odds ratio of device success (adjusted odds ratio, 0.78 95% CI, 0.67-0.90), driven by lower odds of residual mitral gradient <5 mm Hg (adjusted odds ratio, 0.54 CI, 0.46-0.63) when compared with males. At 1-year follow-up, the primary outcome did not differ by sex. Female sex was associated with lower adjusted 1-year risk of all-cause mortality (adjusted hazard ratio, 0.80 CI, 0.68-0.94), but the adjusted 1-year risk of stroke and any bleeding did not differ by sex. CONCLUSIONS: No difference in composite outcome of all-cause mortality, stroke, and any bleeding was observed between females and males. Adjusted 1-year all-cause mortality was lower in females compared with males.
Villablanca et al. (Mon,) conducted a cohort in Mitral regurgitation. Female sex vs. Male sex was evaluated on 1-year major adverse events defined as a composite of all-cause mortality, stroke, and any bleeding. Female sex was associated with a lower 1-year risk of all-cause mortality (HR 0.80; 95% CI 0.68-0.94) compared with males after MitraClip repair, with no difference in the primary composite outcome.