Abstract 12165: Transcatheter Mitral Valve Repair is Safe in Older Adults: Insight From the Nationwide Inpatient Sample Database

Abstract

Introduction: Transcatheter mitral valve repair (TMVR) is an effective treatment for symptomatic mitral insufficiency, however in elderly patients is limited. We compared outcomes clinical outcomes, cost, and complications in adults aged ≥80 years old compared to < 80 years old. Methods: We identified all cases of transcatheter mitral valve repair in patients admitted to hospitals in the United States (US) from 2016 to 2019 using the National Inpatient Sample. We compared outcomes between older adults and younger population using 79 years of age as the cutoff. Results: Out of 3130 patients who underwent TMVR , 33.42 % of patients were over the age ≥80 of years. Half of those patients were female (49.91%). Older patients ≥80 years of age were more likely to have congestive heart failure (79.36 versus 70.13, p<.0001), dyslipidemia (57.64% versus 51.0%, p<.0001), chronic kidney disease (34.66% versus 25.39%, p<.0001), and coronary artery disease (58.51% versus 51.141%, p<.0001). While patients younger than 80 years of age more frequently had diabetes mellitus(29.83% versus 19.92%, p<.0001), hypertension (30.12% versus 21.30%, p<.0001), and smoking(9.09% versus 0.72%, p<.0001). Hospital mortality was lower in patients 80 years of age or older (2.56% versus 4.46%, p<.0001). In addition, hospital length of stay and total charges were lower in the older group (4.93±6.62 days versus 10.85±13.61 days), and ( $222933 ±155969 versus $288776 ±314288, p <.0001). However, multivariable analysis after adjusting for baseline comorbidities mentioned above did not show significant difference in mortality between the two groups (OR 0.792, CI 0.501-1.252). Conclusions: After adjustment for baseline characteristics, patients ≥80 years old and undergoing TMVR have similar in-hospital mortality to patients under age 80. Care for the ≥80 cohort was more costly. The present analysis suggests TMVR is safe in older adults.