Abstract 11362: Revisiting Gender Equality in Mortality After MitraClip Implantation: A Systematic Review and Meta-Analysis

Abstract

Introduction: The presence of gender disparities in outcomes after non-coronary cardiac interventions is well-recognized, but conflicting data have been reported regarding the impact of gender on mortality after MitraClip (MC) implantation. Identification of sex differences in outcomes is important for effective risk stratification in patients with severe mitral regurgitation, who are at high risk for surgery. Hypothesis: We hypothesized that there are no gender-based differences in all-cause mortality after MC procedure. Methods: We searched electronic databases PubMed, Embase, and Web of Science from inception up to May 2021 for studies evaluating patient outcomes after MC implantation. The primary outcome of interest was late all-cause mortality ≥ 1 year after MC procedure. Secondary outcome of interest was in-hospital mortality. A random-effects model meta-analysis was conducted, and heterogeneity was assessed using I-squared test. Results: Seventeen studies comprising 21,549 patients were included. Women constituted 45.2% of the cohort. Male and female genders were not found to be independent predictors of late all-cause mortality ≥ 1 year after MC procedure (male, Hazard Ratio: 1.08; 95% CI: 0.92-1.26; I 2 = 15% and female, Odds Ratio (OR): 0.91; 95% CI: 0.73-1.14; I 2 = 0%, respectively) (Figure 1). There were no differences in in-hospital mortality between women and men after the index procedure (female, OR: 1.06; 95% CI: 0.61-1.85; I 2 = 29%) (Figure 2). Conclusions: There is no gender disparity in mortality with MitraClip implantation, both in-hospital and during long-term follow-up.