Technical and Clinical Outcomes After Transcatheter Edge-to-Edge Repair of Mitral Regurgitation in Male and Female Patients: Is Equality Achieved?

Autor: Biasco L; Department of Biomedical Sciences University of Italian Switzerland Lugano Switzerland.; Azienda Sanitaria Locale Torino 4 Turin Italy., Tersalvi G; Division of Cardiology Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale Lugano Switzerland., Klersy C; Service of Biostatistics & Clinical Trial Center Fondazione IRCCS Policlinico San Matteo Pavia Italy., Benfari G; Division of Cardiology, Department of Medicine University of Verona Verona Italy., Biaggi P; Heart Clinic Zurich, Hirslanden Zurich Switzerland., Corti R; Heart Clinic Zurich, Hirslanden Zurich Switzerland., Curti M; Service of Biostatistics & Clinical Trial Center Fondazione IRCCS Policlinico San Matteo Pavia Italy., Gaemperli O; Heart Clinic Zurich, Hirslanden Zurich Switzerland., Jeger R; Division of Cardiology Triemli Hospital Zürich and University of Basel Basel Switzerland., Maisano F; Division of Cardiovascular Surgery San Raffaele University Hospital Milano Milan Italy., Mueller O; Division of Cardiology University Hospital Lausanne Lausanne Switzerland., Naegeli B; Division of Cardiology Klinik Im Park Zürich Switzerland., Noble S; Division of Cardiology University Hospital Geneve Geneva Switzerland., Praz F; Division of Cardiology University Hospital Bern Bern Switzerland., Toggweiler S; Division of Cardiology, Kantonsspital Luzern Lucerne Switzerland., Valgimigli M; Department of Biomedical Sciences University of Italian Switzerland Lugano Switzerland.; Division of Cardiology Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale Lugano Switzerland., Cristoforetti Y; Department of Biomedical Sciences University of Italian Switzerland Lugano Switzerland., Enriquez-Sarano M; Valve Science Research Center Minneapolis Heart Institute Minneapolis MN USA., Pedrazzini G; Department of Biomedical Sciences University of Italian Switzerland Lugano Switzerland.; Division of Cardiology Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale Lugano Switzerland.
Jazyk: angličtina
Zdroj: Journal of the American Heart Association [J Am Heart Assoc] 2024 Jun 04; Vol. 13 (11), pp. e032706. Date of Electronic Publication: 2024 May 28.
DOI: 10.1161/JAHA.123.032706
Abstrakt: Background: Currently, no clear impact of sex on short- and long-term survival following transcatheter edge-to-edge mitral valve repair (TEER) is evident, although no data are available on postprocedural life expectancy. Our aim was to assess sex-specific differences in outcomes of patients with mitral regurgitation (MR) treated by TEER.
Methods and Results: Short-term and 5-year outcomes in men and women undergoing TEER between 2011 and 2018 who were included in the large, multicenter, real-world MitraSwiss registry were analyzed. Outcomes were compared stratified by sex and according to MR cause (primary versus secondary). The impact of TEER on postprocedural life expectancy was estimated by relative survival analysis. Among 1142 patients aged 60 to 89 years, 39.8% were women. They were older, with fewer cardiovascular risk factors and lower functional capacity compared with men. Thirty-day mortality was higher in men than in women (3.3% versus 1.1%; odds ratio, 3.16 [95% CI, 1.16-10.7]; P =0.020). Five-year survival was comparable in both sexes (adjusted hazard ratio for 5-year mortality in men, 1.14 [95% CI, 0.90-1.44], P =0.275). Both men and women with either primary or secondary MR showed similar clinical efficacy over time. TEER provided high relative survival estimates among all groups, and fully restored predicted life expectancy in women with primary MR (5-year relative survival estimate, 97.4% [95% CI, 85.5-107.0]).
Conclusions: TEER is not associated with increased short-term mortality in women, whereas 5-year outcomes are comparable between sexes. Moreover, TEER completely restored normal life expectancy in women with primary MR. A residual excess mortality persists in secondary MR, independently of sex.
Databáze: MEDLINE
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