Inpatient Outcomes of Tricuspid Transcatheter Edge-to-Edge Repair in the United States Based on Sex

TL;DR

This study finds that female patients undergoing a specific heart repair procedure have better inpatient outcomes and lower mortality compared to male patients in the US.

Contribution

The study is one of the first to analyze national inpatient outcomes of tricuspid transcatheter edge-to-edge repair based on sex in the United States.

Findings

Female patients had lower inpatient mortality, major complications, and cost of stay compared to male patients after T-TEER.

Female patients were older but had fewer comorbidities than male patients undergoing the procedure.

After adjusting for variables, female sex remained independently associated with better outcomes.

Abstract

Tricuspid transcatheter edge-to-edge repair (T-TEER) has emerged as an effective and safe option for the repair of tricuspid regurgitation in select patients. Prior studies on invasive and percutaneous cardiac interventions have shown differential outcomes based on sex, but specific studies investigating T-TEER outcomes on a national level are limited.

The National Inpatient Sample and International Classification of Diseases, Tenth Revision codes were used to identify patients who underwent T-TEER in the US from 2018 to 2021. The study group was then stratified based on sex. Study end points assessed included inpatient complications, outcomes, and resource utilization after T-TEER. A multivariable logistic regression model was used to assess the independent association of sex with study outcomes.

A total of 1960 T-TEER procedures were identified, of which 1210 occurred in female patients (61.7%). Female patients were older and generally had a lower prevalence of important comorbidities than male patients. In unadjusted analysis, female sex was associated with lower prevalence of major, overall, and cardiovascular complications, inpatient mortality, and length and cost of stay. After multivariable adjustment, female sex was associated with lower inpatient mortality (adjusted odds ratio [aOR], 0.43; 95% CI, 0.22-0.82), lower major complications, (aOR, 0.69; 95% CI, 0.49-0.98), and lower cost of stay (aOR, 0.67; 95% CI, 0.55-0.82).

Female sex was associated with similar or better inpatient outcomes and mortality after T-TEER when compared with male sex. Further investigation to understand the etiology behind these important differences is encouraged to promote improved cardiovascular care and outcomes in patients regardless of sex.

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