A systematic review and meta-analysis found no sex-specific biases for inpatient or long-term all-cause mortality following MitraClip implantation. These findings were presented at the American Heart Association (AHA) Scientific Sessions 2021, held virtually from November 13 to 15, 2021.
It is a well-established fact that there are sex disparities in clinical outcomes after noncoronary cardiac interventions. However, there have been conflicting data published about whether there are sex-specific differences regarding mortality after receiving MitraClip implantation. Identifying potential risk disparities among men and women is needed in order to effectively stratify patients with severe mitral regurgitation, as this population is at high risk for surgery.
To better assess sex-based differences in MitraClip-associated mortality, researchers from Albert Einstein College of Medicine in New York and Indira Gandhi Medical College and Research Institute in India searched publication databases through May 2021 for studies that evaluated inpatient and/or long-term (≥1 year) all-cause mortality following MitraClip implantation.
A total of 17 studies comprising 21,549 patients were included in this analysis. The patient population was 45.2% women.
All-cause mortality at greater than or equal to 1 year after MitraClip implantation did not differ significantly between men (n=9 studies; hazard ratio [HR], 1.08; 95% CI, 0.92-1.26; I2, 15%) or women (n=6 studies; odds ratio [OR], 0.91; 95% CI, 0.73-1.14; I2, 0%).
A similar pattern was observed for in-hospital all-cause mortality following MitraClip implantation, in which compared with men, women were not at increased risk for in-hospital mortality (n=4 studies; OR, 1.06; 95% CI, 0.61-1.85; I2, 29%).
The study authors concluded that unlike other noncoronary cardiac interventions, there was no disparity for in-hospital or long-term all-cause mortality following MitraClip implantation.
Nagraj S, Safiriyu I, Mathai SV, Bs L, Faillace R. Revisiting gender equality in mortality after MitraClip implantation: a systematic review and meta-analysis. Presented at: AHA Scientific Sessions 2021. Abstract P1426