Transcatheter Mitral Valve Repair in Surgical High-Risk Patients: Gender-Specific Acute and Long-Term Outcomes

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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4793092/
https://www.ncbi.nlm.nih.gov/pubmed/27042662
http://dx.doi.org/10.1155/2016/3934842
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author 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
author_facet 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
author_sort Tigges, Eike
collection PubMed
description 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.
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spelling pubmed-47930922016-04-03 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 Biomed Res Int Clinical Study 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. Hindawi Publishing Corporation 2016 2016-03-02 /pmc/articles/PMC4793092/ /pubmed/27042662 http://dx.doi.org/10.1155/2016/3934842 Text en Copyright © 2016 Eike Tigges et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
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
Transcatheter Mitral Valve Repair in Surgical High-Risk Patients: Gender-Specific Acute and Long-Term Outcomes
title Transcatheter Mitral Valve Repair in Surgical High-Risk Patients: Gender-Specific Acute and Long-Term Outcomes
title_full Transcatheter Mitral Valve Repair in Surgical High-Risk Patients: Gender-Specific Acute and Long-Term Outcomes
title_fullStr Transcatheter Mitral Valve Repair in Surgical High-Risk Patients: Gender-Specific Acute and Long-Term Outcomes
title_full_unstemmed Transcatheter Mitral Valve Repair in Surgical High-Risk Patients: Gender-Specific Acute and Long-Term Outcomes
title_short Transcatheter Mitral Valve Repair in Surgical High-Risk Patients: Gender-Specific Acute and Long-Term Outcomes
title_sort transcatheter mitral valve repair in surgical high-risk patients: gender-specific acute and long-term outcomes
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4793092/
https://www.ncbi.nlm.nih.gov/pubmed/27042662
http://dx.doi.org/10.1155/2016/3934842
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