Sex Differences in Epidemiological Distribution and Outcomes of Surgical Mitral Valve Disease

Background: Mitral valve (MV) disease is the most common form of valvular heart disease. Findings that indicate women have a higher risk for unfavorable outcomes than men remain controversial. This study aimed to determine the sex-based differences in epidemiological distributions and outcomes of su...

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Published in:Circulation Journal 2024/03/25, Vol.88(4), pp.579-588
Main Authors: Chang, Feng-Cheng, Chen, Chun-Yu, Chan, Yi-Hsin, Cheng, Yu-Ting, Lin, Chia-Pin, Wu, Victor Chien-Chia, Hung, Kuo-Chun, Chu, Pao-Hsien, Chou, An-Hsun, Chen, Shao-Wei
Format: Article
Language:English
Subjects:
Endocarditis
Endocarditis, Bacterial - surgery
Female
Heart Valve Diseases - epidemiology
Heart Valve Diseases - surgery
Heart Valve Prosthesis Implantation - adverse effects
Hospital Mortality
Humans
Male
Mitral Valve - surgery
Mitral Valve Insufficiency - epidemiology
Mitral Valve Insufficiency - etiology
Mitral Valve Insufficiency - surgery
Mortality
Renal Dialysis
Retrospective Studies
Sex Characteristics
Sex differences
Treatment Outcome
Women
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Summary:Background: Mitral valve (MV) disease is the most common form of valvular heart disease. Findings that indicate women have a higher risk for unfavorable outcomes than men remain controversial. This study aimed to determine the sex-based differences in epidemiological distributions and outcomes of surgery for MV disease.Methods and Results: Overall, 18,572 patients (45.3% women) who underwent MV surgery between 2001 and 2018 were included. Outcomes included in-hospital death and all-cause mortality during follow up. Subgroup analysis was conducted across different etiologies, including infective endocarditis (IE), degenerative, ischemic, and rheumatic mitral pathology. The overall MV repair rate was lower in women than in men (20.5% vs. 30.6%). After matching, 6,362 pairs (woman : man=1 : 1) of patients were analyzed. Women had a slightly higher risk for in-hospital death than men (10.8% vs. 9.8%; odds ratio [OR]: 1.11, 95% confidence interval [CI]: 0.99–1.24; P=0.075). Women tended to have a higher incidence of de novo dialysis (9.8% vs. 8.6%; P=0.022) and longer intensive care unit stay (8 days vs. 7.1 days; P
ISSN:1346-9843
1347-4820
1347-4820
DOI:10.1253/circj.CJ-23-0687