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. 2016:2016:3934842.
doi: 10.1155/2016/3934842. Epub 2016 Mar 2.

Transcatheter Mitral Valve Repair in Surgical High-Risk Patients: Gender-Specific Acute and Long-Term Outcomes

Eike Tigges  1 , Daniel Kalbacher  1 , Christina Thomas  1 , Sebastian Appelbaum  1 , Florian Deuschl  1 , Niklas Schofer  1 , Michael Schlüter  2 , Lenard Conradi  3 , Johannes Schirmer  3 , Hendrik Treede  3 , Hermann Reichenspurner  3 , Stefan Blankenberg  1 , Ulrich Schäfer  1 , Edith Lubos  1
Affiliations

Transcatheter Mitral Valve Repair in Surgical High-Risk Patients: Gender-Specific Acute and Long-Term Outcomes

Eike Tigges et al. Biomed Res Int. 2016.

Abstract

Background: Analyses emphasizing gender-related differences in acute and long-term outcomes following MitraClip therapy for significant mitral regurgitation (MR) are rare.

Methods: 592 consecutive patients (75 ± 8.7 years, 362 men, 230 women) underwent clinical and echocardiographic follow-up for a median of 2.13 (0.99-4.02) years.

Results: Significantly higher prevalence of cardiovascular comorbidities, renal failure, and adverse echocardiographic parameters in men resulted in longer device time (p = 0.007) and higher numbers of implanted clips (p = 0.0075), with equal procedural success (p = 1.0). Rehospitalization for heart failure did not differ (p[logrank] = 0.288) while survival was higher in women (p[logrank] = 0.0317). Logarithmic increase of NT-proBNP was a common independent predictor of death. Hypercholesterolemia and peripheral artery disease were predictors of death only in men while ischemic and dilative cardiomyopathy (CM) and age were predictors in women. Independent predictors of rehospitalization for heart failure were severely reduced ejection fraction and success in men while both ischemic and dilative CM, logistic EuroSCORE, and MR severity were predictive in women.

Conclusions: Higher numbers of implanted clips and longer device time are likely related to more comorbidities in men. Procedural success and acute and mid-term clinical outcomes were equal. Superior survival for women in long-term analysis is presumably attributable to a comparatively better preprocedural health.

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Figures

Figure 1
Figure 1
Kaplan-Meier curves presenting the cumulative incidence of death of all causes during follow-up according to gender.
Figure 2
Figure 2
Kaplan-Meier curves presenting the incidence of rehospitalization for heart failure during follow-up according to gender.
See this image and copyright information in PMC

References

    1. Iung B., Baron G., Tornos P., Gohlke-Bärwolf C., Butchart E. G., Vahanian A. Valvular heart disease in the community: a European experience. Current Problems in Cardiology. 2007;32(11):609–661. doi: 10.1016/j.cpcardiol.2007.07.002. - DOI - PubMed
    1. Feldman T., Foster E., Glower D. G., et al. Percutaneous repair or surgery for mitral regurgitation. The New England Journal of Medicine. 2011;364(15):1395–1406. doi: 10.1056/nejmoa1009355. - DOI - PubMed
    1. Rudolph V., Knap M., Franzen O., et al. Echocardiographic and clinical outcomes of MitraClip therapy in patients not amenable to surgery. Journal of the American College of Cardiology. 2011;58(21):2190–2195. doi: 10.1016/j.jacc.2011.07.047. - DOI - PubMed
    1. Lubos E., Schlüter M., Vettorazzi E., et al. MitraClip therapy in surgical high-risk patients: identification of echocardiographic variables affecting acute procedural outcome. JACC Cardiovascular Interventions. 2014;7(4):394–402. doi: 10.1016/j.jcin.2013.12.198. - DOI - PubMed
    1. Puls M., Tichelbäcker T., Bleckmann A., et al. Failure of acute procedural success predicts adverse outcome after percutaneous edge-to-edge mitral valve repair with MitraClip. EuroIntervention. 2014;9(12):1407–1417. doi: 10.4244/eijv9i12a238. - DOI - PubMed

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