Transcatheter Mitral Valve Repair in Surgical High-Risk Patients: Gender-Specific Acute and Long-Term Outcomes
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Transcatheter Mitral Valve Repair in Surgical High-Risk Patients: Gender-Specific Acute and Long-Term Outcomes. / Tigges, Eike; Kalbacher, Daniel; Thomas, Christina; Appelbaum, Sebastian; Deuschl, Florian; Schofer, Niklas; Schlüter, Michael; Conradi, Lenard; Schirmer, Johannes; Treede, Hendrik; Reichenspurner, Hermann; Blankenberg, Stefan; Schäfer, Ulrich; Lubos, Edith.
in: BIOMED RES INT , Jahrgang 2016, 2016, S. 3934842.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Transcatheter Mitral Valve Repair in Surgical High-Risk Patients: Gender-Specific Acute and Long-Term Outcomes
AU - Tigges, Eike
AU - Kalbacher, Daniel
AU - Thomas, Christina
AU - Appelbaum, Sebastian
AU - Deuschl, Florian
AU - Schofer, Niklas
AU - Schlüter, Michael
AU - Conradi, Lenard
AU - Schirmer, Johannes
AU - Treede, Hendrik
AU - Reichenspurner, Hermann
AU - Blankenberg, Stefan
AU - Schäfer, Ulrich
AU - Lubos, Edith
PY - 2016
Y1 - 2016
N2 - BACKGROUND: Analyses emphasizing gender-related differences in acute and long-term outcomes following MitraClip therapy for significant mitral regurgitation (MR) are rare.METHODS: 592 consecutive patients (75 ± 8.7 years, 362 men, 230 women) underwent clinical and echocardiographic follow-up for a median of 2.13 (0.99-4.02) years.RESULTS: Significantly higher prevalence of cardiovascular comorbidities, renal failure, and adverse echocardiographic parameters in men resulted in longer device time (p = 0.007) and higher numbers of implanted clips (p = 0.0075), with equal procedural success (p = 1.0). Rehospitalization for heart failure did not differ (p[logrank] = 0.288) while survival was higher in women (p[logrank] = 0.0317). Logarithmic increase of NT-proBNP was a common independent predictor of death. Hypercholesterolemia and peripheral artery disease were predictors of death only in men while ischemic and dilative cardiomyopathy (CM) and age were predictors in women. Independent predictors of rehospitalization for heart failure were severely reduced ejection fraction and success in men while both ischemic and dilative CM, logistic EuroSCORE, and MR severity were predictive in women.CONCLUSIONS: Higher numbers of implanted clips and longer device time are likely related to more comorbidities in men. Procedural success and acute and mid-term clinical outcomes were equal. Superior survival for women in long-term analysis is presumably attributable to a comparatively better preprocedural health.
AB - BACKGROUND: Analyses emphasizing gender-related differences in acute and long-term outcomes following MitraClip therapy for significant mitral regurgitation (MR) are rare.METHODS: 592 consecutive patients (75 ± 8.7 years, 362 men, 230 women) underwent clinical and echocardiographic follow-up for a median of 2.13 (0.99-4.02) years.RESULTS: Significantly higher prevalence of cardiovascular comorbidities, renal failure, and adverse echocardiographic parameters in men resulted in longer device time (p = 0.007) and higher numbers of implanted clips (p = 0.0075), with equal procedural success (p = 1.0). Rehospitalization for heart failure did not differ (p[logrank] = 0.288) while survival was higher in women (p[logrank] = 0.0317). Logarithmic increase of NT-proBNP was a common independent predictor of death. Hypercholesterolemia and peripheral artery disease were predictors of death only in men while ischemic and dilative cardiomyopathy (CM) and age were predictors in women. Independent predictors of rehospitalization for heart failure were severely reduced ejection fraction and success in men while both ischemic and dilative CM, logistic EuroSCORE, and MR severity were predictive in women.CONCLUSIONS: Higher numbers of implanted clips and longer device time are likely related to more comorbidities in men. Procedural success and acute and mid-term clinical outcomes were equal. Superior survival for women in long-term analysis is presumably attributable to a comparatively better preprocedural health.
KW - Aged
KW - Aged, 80 and over
KW - Cardiomyopathies/complications
KW - Echocardiography/adverse effects
KW - Female
KW - Heart Failure/complications
KW - Humans
KW - Male
KW - Middle Aged
KW - Mitral Valve/physiopathology
KW - Mitral Valve Insufficiency/complications
KW - Postoperative Complications/epidemiology
KW - Severity of Illness Index
KW - Sex Characteristics
KW - Treatment Outcome
U2 - 10.1155/2016/3934842
DO - 10.1155/2016/3934842
M3 - SCORING: Journal article
C2 - 27042662
VL - 2016
SP - 3934842
JO - BIOMED RES INT
JF - BIOMED RES INT
SN - 2314-6133
ER -