D-35 | Pre-Procedural Anemia and Long-Term Outcomes in Patients Undergoing Transcatheter Mitral Valve Repair: A Meta Analysis

Abstract

Transcatheter mitral valve repair (TMVr) is an effective treatment option for mitral regurgitation especially in elderly patients with multiple comorbidities, including anemia. Literature review on outcomes of TMVr in anemic patients has mixed results. Pubmed, Embase, and Scopus databases were systematically reviewed to find studies through august 2022, reporting data on pre-procedural anemia and mortality in TMVr. Random effects models were used to estimate pooled odds of all-cause mortality at 1 year and 2 year median follow-up. I2 statistics were used to report inter-study heterogeneity. Impact of individual study on the overall estimate assessed with Leave one out sensitivity analysis. p<0.05 was considered statistically significant. Seven studies [5 retrospective, 2 prospective] were included in analysis. Of the 6,406 TMVr patients 2,109 [32.9%] had anemia. Hypertension, DM, CKD, Atrial fibrillation and CAD were prevalent comorbidities found in anemic patients. No significant increase seen in unadjusted all-cause mortality at 1 year (OR 1.23, 95% CI 0.53-2.84, p 0.63). However, pooled analysis revealed increased odds of all-cause mortality at 2 years for both adjusted (aOR 1.39 95%CI 1.01-1.91, p 0.04) and unadjusted (OR 1.85 95%CI 1.55-2.21, p<0.01) analyses [Fig. 1] Pre-procedural anemia increased odds of 2-year mortality in patients undergoing TMVr. Further controlled studies are needed to confirm association of anemia with long term survival post-TMVr.