University of Hawaii Internal Medicine Residency Program, Honolulu, HI, USA.
Internal Medicine Residency Program, Bassett Healthcare Network, NY, USA.
Cardiovasc Revasc Med. 2022 Jul;40:20-25. doi: 10.1016/j.carrev.2021.11.012. Epub 2021 Nov 10.
Transcatheter edge-to-edge repair (TEER) of the mitral valve with MitraClip therapy is an emerging treatment in selected patients with severe mitral regurgitation. Identifying the patient with increased risk of poorer outcomes, including mortality, is crucial in these patients. Recent studies suggested conflicting data regarding the effects of gender on outcome in this patient population. We evaluate the impact of gender on the outcome of patients undergoing MitraClip therapy by systematic review and meta-analysis.
The authors comprehensively searched the databases of EMBASE and MEDLINE from inception to April 2021. Included studies were published cohorts reporting univariate or multivariate analysis of the effects of gender on in-hospital and overall mortality among patients undergoing MitraClip therapy. Data from each study were combined using the random-effects, generic inverse variance method of DerSimonioan and Laird.
A total of nine studies were included in this meta-analysis, including 9062 patients. Male gender is associated with higher in-hospital mortality with pooled OR 1.81 (95% confidence interval 1.01-3.22, p-value 0.045) and overall mortality with pooled OR 1.19 (95% CI 1.06-1.33, p-value 0.003).
According to our meta-analysis, the male gender increases the risk of in-hospital mortality up to 1.81 folds and overall mortality up to 1.19 folds.
经导管缘对缘修复（TEER）联合 MitraClip 治疗二尖瓣是一种新兴的治疗方法，适用于特定的重度二尖瓣反流患者。在这些患者中，识别出具有更高不良结局风险（包括死亡率）的患者至关重要。最近的研究表明，关于性别对该患者人群结局影响的数据存在冲突。我们通过系统评价和荟萃分析评估了性别对接受 MitraClip 治疗的患者结局的影响。
作者全面检索了 EMBASE 和 MEDLINE 数据库，检索时间截至 2021 年 4 月。纳入的研究是发表的队列研究，报告了性别对接受 MitraClip 治疗的患者住院期间和总死亡率的单因素或多因素分析。使用 DerSimonian 和 Laird 的随机效应、通用逆方差方法对每项研究的数据进行合并。
本荟萃分析共纳入 9 项研究，共 9062 例患者。男性性别与更高的住院死亡率相关，合并 OR 为 1.81（95%可信区间 1.01-3.22，p 值=0.045）和总死亡率相关，合并 OR 为 1.19（95%可信区间 1.06-1.33，p 值=0.003）。
根据我们的荟萃分析，男性性别使住院死亡率增加 1.81 倍，总死亡率增加 1.19 倍。
