Abstract 16574: Short Term Outcomes With Mitraclip in Women Compared With Men: Evidence From a Meta-analysis

Introduction: MitraClip is now approved for severe functional mitral regurgitation in high-risk patients with contraindications to surgical mitral valve repair. Previous studies have shown conflicting results with respect to sex differences in outcomes with the MitraClip. This study sought to examine short-term outcomes with transcatheter mitraclip in women versus men. Hypothesis: Female patients will have higher all-cause mortality, major cardiovascular events, and complications than men following MitraClip. Methods: Electronic search was performed until April 2020 for studies reporting outcomes with MitraClip in women versus men. Random effects DerSimonian-Laird odds ratios were calculated. Outcomes included all-cause mortality and major cardiovascular events at short-term follow-up (in hospital or 30 days) as well as complications. Results: Six studies (4 MitraClip registries; 2344 patients; 925 women) were analyzed. Women were older but exhibited fewer comorbidities. At 30 days, men had more strokes (p < 0.0347) and major vascular complications (p < 0.042), without a difference in all-cause and cardiovascular mortality (OR 1.31, 0.67-2.57, p <0.43) compared with men. There was no difference in pericardial effusion/cardiac tamponade (p <0.311) or acute renal failure (p <0.805). The female survival advantage remained consistent across multiple secondary analyses. The risk of stroke, moderate/severe aortic insufficiency, and all-cause mortality seemed to vary based on the type of valve used; however, without significant subgroup interactions. Conclusions: Despite conflicting data, women experience better short-term outcomes with the MitraClip repair.