Sex-Related Clinical Characteristics and Outcomes of Patients Undergoing Transcatheter Edge-to-Edge Repair for Secondary Mitral Regurgitation |
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| Authors: | Sang-Don Park Mathias Orban Nicole Karam Edith Lubos Daniel Kalbacher Daniel Braun Lukas Stolz Michael Neuss Christian Butter Fabien Praz Mohammad Kassar Aniela Petrescu Roman Pfister Christos Iliadis Matthias Unterhuber Philipp Lurz Holger Thiele Stephan Baldus Jörg Hausleiter |
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| Affiliation: | 1. Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Munich, Germany;2. Department of Cardiology, Inha University Hospital, Incheon, Korea Republic;3. Munich Heart Alliance, Partner Site German Center for Cardiovascular Disease (DZHK), Munich, Germany;4. Department of Cardiology, European Hospital Georges Pompidou, and INSERM U970, Paris Cardiovascular Research Center, Paris, France;5. Universitäres Herz und Gefäßzentrum UKE Hamburg, Klinik für Kardiologie, Hamburg, Germany;6. Herzzentrum Brandenburg, Medizinische Hochschule Brandenburg Theodor Fontane, Bernau, Germany;7. Universitätsklinik für Kardiologie, Inselspital Bern, Switzerland;8. Zentrum für Kardiologie, Johannes Gutenberg-Universität, Mainz, Germany;9. Department III of Internal Medicine, Heart Center, University of Cologne, Cologne, Germany;10. Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany |
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| Abstract: | ObjectivesThe authors sought to assess sex-based differences in characteristics and outcomes of patients undergoing transcatheter edge-to-edge mitral valve repair (TMVR) for secondary mitral regurgitation (SMR).BackgroundSubgroup analysis from the COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation) trial indicated potential sex-related differences in outcomes after TMVR. The impact of sex on results after TMVR in a real-world setting is unknown.MethodsThe authors assessed clinical outcomes and echocardiographic parameters in women and men undergoing TMVR for SMR between 2008 and 2018 who were included in the large, international, multicenter real-world EuroSMR registry (European Registry of Transcatheter Repair for Secondary Mitral Regurgitation).ResultsA total of 1,233 patients, including 445 women (36%) and 788 men (64%), were analyzed. Although women were significantly older and had fewer comorbidities than men, TMVR was equally effective in women and men (mitral regurgitation [MR] grade ≤2+ at discharge: 93.2% vs. 94.6% for women vs. men; p = 0.35). All-cause mortality at 1 year (17.9% vs. 18.9%, adjusted hazard ratio: 0.806; p = 0.46) and at 2-year follow-up (26.5% vs. 26.4%, adjusted hazard ratio: 0.757; p = 0.26) were similar in women versus men after multivariate regression analysis. Durability of MR reduction, improvement in symptoms, quality of life, and functional capacity did also not differ during follow-up.ConclusionsResults from the EuroSMR registry confirmed effective and similar MR reduction with TMVR in women and men. There were no sex-related differences in clinical outcomes up to 2 years of follow-up. |
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