Sex Differences in In-Hospital Outcomes of Transcatheter Mitral Valve Repair (from a National Database)

Ayman Elbadawi, Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, Texas.
Mohammed Elzeneini, Department of Internal Medicine, University of Florida, Gainesville, Florida.
Ravi Thakker, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
Karim Mahmoud, Department of Internal Medicine, Houston Medical Center, Warner Robins, Georgia.
Islam Y. Elgendy, Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Michael Megaly, Department of Cardiovascular Medicine, Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota.
Mohamed Hamed, Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, Texas.
Mohmed A. Omer, Department of Cardiovascular Medicine, Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota.
Medhat Chowdhury, Rochester Regional HealthFollow
Gbolahan Ogunbayo, Division of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky.
Diaa Kamal, Division of Cardiovascular Medicine, Ain Shams University, Cairo, Egypt.
Uma Rangassety, Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, Texas.
Hani Jneid, Division of Cardiovascular Medicine, Baylor School of Medicine, Houston, Texas.
Syed Gilani, Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, Texas.
Wissam Khalife, Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, Texas.

Department

Internal Medicine

Document Type

Article

Publication Title

American Journal of Cardiology

Abstract

There is paucity of data on sex differences in outcomes of transcatheter mitral valve repair (TMVR). We queried the National Inpatient Sample database (2012-2016) to identify hospitalizations for TMVR. We conducted a propensity matching analysis to compare hospitalizations for TMVR in men versus women. Our analysis yielded 10,014 hospitalizations for TMVR. TMVR was increasingly performed in both sexes at similar rate. Compared with men, women undergoing TMVR had fewer major comorbidities. After matching, there was no difference in in-hospital mortality between men and women (3.0% vs 2.4%, p = 0.33). Also, there was no difference between men and women in cardiac arrest (2.1% vs 1.3%, p = 0.17), cardiogenic shock (3.9% vs 3.5%, p = 0.66), mechanical support devices (2.4% vs 2.9%, p = 0.45), acute kidney injury (17.8% vs 14.7%, p = 0.08), hemodialysis (1.7% vs 1.6%, p = 0.81), respiratory complications (1.7% vs 1.4%, p = 0.65), acute stroke (1.4% vs 1.3%, p = 0.82), discharges to nursing facilities (12.3% vs 15.2%, p = 0.09), tamponade (0.5% vs 0.4%, p = 0.69), acute myocardial infarction (2.1% vs 2.4%, p = 0.71), and mean length of stay (6.03 ± 8.153 vs 6.08 ± 8.858 days, p = 0.82). TMVR in men was associated with higher incidence of ventricular arrhythmias (7.2% vs 4.1%, p = 0.01) and lower incidence of pacemaker implantations (0.4% vs 1.7%, p = 0.01). In conclusion, this observational study showed that TMVR is increasingly performed in both sexes at similar rate. Despite that women had less comorbidities, there was no difference in in-hospital mortality and major complications for TMVR among women compared with men. Future studies comparing the differences between both sexes in long-term outcomes are encouraged.

First Page

1391

Last Page

1397

DOI

10.1016/j.amjcard.2020.01.013

Volume

125

Issue

9

Publication Date

5-1-2020

Medical Subject Headings

Aged; Aged, 80 and over; Cardiac Catheterization; Cardiac Surgical Procedures (methods); Databases, Factual; Female; Hospital Mortality; Humans; Male; Middle Aged; Mitral Valve (surgery); Mitral Valve Insufficiency (surgery); Postoperative Complications (epidemiology); Sex Factors; Treatment Outcome; United States

PubMed ID

32151434

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