Impact of sex on short term in-hospital outcomes with transcatheter edge-to-edge mitral valve repair.

BACKGROUND AND AIM OF THE STUDY: Transcatheter edge-to-edge mitral valve repair with the mitraclip device for treatment of severe mitral regurgitation has been shown to be an effective treatment. However, the impact of sex on in-hospital outcomes has not been studied on a large scale with "real-world" patients. The aim of this study was to assess for disparities of sex in patients treated with mitraclip.

MATERIALS AND METHODS: Data from the National Inpatient Sample (NIS) (2012 through 2014) using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure code 35.97 for transcatheter mitral valve repair was analyzed for this study. SAS 9.4 (SAS institute, Cary, NC) was used for univariate and multivariate analysis. Multivariate analysis was used to adjust for various confounders.

RESULTS: A total of 521 patients were identified that were treated with MitraClip, with 57.97% males (n=302) and 42.03% females (n=219). There was no significant difference in the primary outcome, in-hospital mortality between two sex [2.6% vs. 3.6%, p=0.43, Odds Ratio 1.62 (95% Confidence Interval, 0.50-5.28)]. After performing multivariate analysis, no difference in any secondary outcomes existed. Additionally, length of stay and median hospitalization cost was similar regardless of sex.

CONCLUSIONS: Analysis of this large database of patients undergoing treatment with MitraClip suggests that MitraClip in females is not associated with increased in-hospital mortality, morbidity, length of stay or cost. A prospective registry with excluded patients from the clinical trials needed to be fully access if sex disparities in patients being treated with MitraClip exist.