Sex Differences in In-Hospital Outcomes of Transcatheter Mitral Valve Repair (from a National Database)

Abstract

There is paucity of data on sex differences in outcomes of transcatheter mitral valve repair (TMVR). We queried the National Inpatient Sample database (2012-2016) to identify hospitalizations for TMVR. We conducted a propensity matching analysis to compare hospitalizations for TMVR in men versus women. Our analysis yielded 10,014 hospitalizations for TMVR. TMVR was increasingly performed in both sexes at similar rate. Compared with men, women undergoing TMVR had fewer major comorbidities. After matching, there was no difference in in-hospital mortality between men and women (3.0% vs 2.4%, p = 0.33). Also, there was no difference between men and women in cardiac arrest (2.1% vs 1.3%, p = 0.17), cardiogenic shock (3.9% vs 3.5%, p = 0.66), mechanical support devices (2.4% vs 2.9%, p = 0.45), acute kidney injury (17.8% vs 14.7%, p = 0.08), hemodialysis (1.7% vs 1.6%, p = 0.81), respiratory complications (1.7% vs 1.4%, p = 0.65), acute stroke (1.4% vs 1.3%, p = 0.82), discharges to nursing facilities (12.3% vs 15.2%, p = 0.09), tamponade (0.5% vs 0.4%, p = 0.69), acute myocardial infarction (2.1% vs 2.4%, p = 0.71), and mean length of stay (6.03 ± 8.153 vs 6.08 ± 8.858 days, p = 0.82). TMVR in men was associated with higher incidence of ventricular arrhythmias (7.2% vs 4.1%, p = 0.01) and lower incidence of pacemaker implantations (0.4% vs 1.7%, p = 0.01). In conclusion, this observational study showed that TMVR is increasingly performed in both sexes at similar rate. Despite that women had less comorbidities, there was no difference in in-hospital mortality and major complications for TMVR among women compared with men. Future studies comparing the differences between both sexes in long-term outcomes are encouraged.