title: Effect of gender on results of percutaneous edge-to-edge mitral valve repair with MitraClip system.
abstract: Knowledge regarding gender-specific results of percutaneous edge-to-edge mitral valve repair is scarce. The aim of this study was to investigate gender differences in outcomes in a cohort of patients treated with MitraClip implantation. A multicenter registry of 173 patients treated with MitraClip prostheses from 2009 to 2012 at 3 experienced centers was performed. One hundred nine patients (63%) were men. Men were younger (mean age 73 ± 10 vs 79 ± 9 years, p = 0.001) and had a higher prevalence of previous coronary bypass graft surgery (34% vs 13%, p = 0.002), previous myocardial infarction (46% vs 20%, p = 0.001), and diabetes mellitus (26% vs 11%, p = 0.020). There were no differences regarding New York Heart Association (NYHA) functional class before the intervention (NYHA class III or IV in 95% of men vs 97% of women, p = 0.472) or the cause of mitral regurgitation (MR) (functional in 58% of men vs 48% of women, p = 0.233). Men exhibited significantly larger ventricles (mean indexed left ventricular end-systolic diameter 2.4 ± 0.8 vs 2.0 ± 1.6 cm/m(2), p = 0.002, and mean indexed left ventricular end-diastolic volume 92.7 ± 46.1 vs 59.9 ± 24.6 ml/m(2), p <0.001). At 1 month, there were no differences between groups in the reduction of MR or NYHA functional class (MR grade ≤2+ in 98.2% of men vs 96.8% of women, p = 0.586, and NYHA class ≤II in 78.3% of men vs 77% of women, p = 0.851). At 6 months, results were maintained (MR grade ≤2+ in 89.5% of men vs 96.8% of women, p = 0.414, and NYHA class ≤II in 73.1% of men vs 74.2% of women, p = 0.912). After a mean follow-up period of 16.1 ± 11.1 months, no difference was found between groups in the incidence of death or admission for heart failure (log-rank p = 0.798). In conclusion, MitraClip implantation seems to be an equally safe and effective treatment of MR in men and women.
authors.affiliation: Department of Cardiology, National Institute Health Research Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom. Electronic address: roiestevez@hotmail.com.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Estévez-Loureiro
authors.affiliation: Unit for Interventional Cardiology, Department of Cardiology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Settergren
authors.affiliation: Unit for Interventional Cardiology, Department of Cardiology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Reidar
authors.initials: R
authors.lastname: Winter
authors.affiliation: Unit for Interventional Cardiology, Department of Cardiology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Jacobsen
authors.affiliation: Department of Cardiology, National Institute Health Research Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom.
authors.forename: Gianni
authors.initials: G
authors.lastname: Dall'Ara
authors.affiliation: Division of Cardiology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Sondergaard
authors.affiliation: Division of Cardiology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Gary
authors.initials: G
authors.lastname: Cheung
authors.affiliation: Department of Cardiology, National Institute Health Research Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom.
authors.forename: Michele
authors.initials: M
authors.lastname: Pighi
authors.affiliation: Department of Cardiology, National Institute Health Research Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom.
authors.forename: Matteo
authors.initials: M
authors.lastname: Ghione
authors.affiliation: Division of Cardiology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Nikolaj
authors.initials: N
authors.lastname: Ihlemann
authors.affiliation: Department of Cardiology, National Institute Health Research Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom.
authors.forename: Neil E
authors.initials: NE
authors.lastname: Moat
authors.affiliation: Department of Cardiology, National Institute Health Research Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom.
authors.forename: Susanna
authors.initials: S
authors.lastname: Price
authors.affiliation: Division of Cardiology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Tine
authors.initials: T
authors.lastname: Streit Rosenberg
authors.affiliation: Department of Cardiology, National Institute Health Research Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom.
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
authors.affiliation: Division of Cardiology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Olaf
authors.initials: O
authors.lastname: Franzen
mesh_terms: D000368:Aged; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008944:Mitral Valve Insufficiency / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D011474:Prosthesis Design; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology