Gender-related differences on outcome following transcatheter mitral valve repair (TMVR): a systematic review and meta-analysis

J Cardiothorac Surg. 2023 Jan 17;18(1):31. doi: 10.1186/s13019-023-02123-6.

Abstract

Background: The effect of gender on patients with mitral valve regurgitation (MR) undergoing transcatheter mitral valve repair (TMVR) remains to be defined. The aim of the present study is a comprehensive meta-analysis of studies that investigate differences between men and women after TMVR.

Methods: A systematic literature search was carried out on eight databases to collect all relevant studies on gender-related outcomes of TMVR before March 1, 2021. The main outcomes of interest were mortality, cardiac function, MR class and other complications.

Results: A total of eight literatures were included, all of which were retrospective observational studies. Compared to women patients, men had lower postoperative New York Heart Association (NYHA) class (OR = 1.53, 95%CI [1.23, 1.91], P = 0.0001) and higher incidence of postoperative acute kidney injury (AKI) (OR = 1.25, 95%CI [1.16, 1.34], P < 0.05). There were no significant difference on mortality in 30 days (OR = 0.95, 95%CI [0.81, 1.11], P = 0.53) and in 2 years (OR = 0.99, 95%CI [0.75, 1.30], P = 0.93), mitral valve regurgitation (MR) class (OR = 1.30, 95%CI [0.97, 1.75], P = 0.08) and incidence of myocardial infarction (MI) (OR = 0.88, 95%CI [0.65, 1.18], P = 0.38), stroke (OR = 0.80, 95%CI [0.63, 1.02], P = 0.08) and bleeding in hospital (OR = 0.84, 95%CI [0.59, 1.19], P = 0.32).

Conclusions: Our meta-analysis demonstrates that men undergoing TMVR have worse preoperative diseases (diabetes mellitus, coronary artery disease, renal failure and myocardial infarction) while they have superior postoperative NYHA class at one-year. There are no significantly difference in other indexes between men and women.

Keywords: Gender differences; Meta-analysis; MitraClip; Mitral valve regurgitation; Systematic reviews; Transcatheter mitral valve repair.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Cardiac Catheterization / adverse effects
  • Female
  • Heart Valve Prosthesis Implantation* / adverse effects
  • Humans
  • Male
  • Mitral Valve / surgery
  • Mitral Valve Insufficiency*
  • Myocardial Infarction* / etiology
  • Retrospective Studies
  • Treatment Outcome