The Influence of Sex on Clinical Outcomes after Surgical Mitral Valve Replacement in Spain (2001–2015)
(1) Background: Mitral regurgitation (MR) is the second most prevalent valvular heart disease in developed countries. Mitral valve (MV) disease is a common cause of heart failure and a leading cause of morbidity and mortality in the U.S.A. and Europe. (2) Methods: We performed a retrospective study...
Main Authors: | , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2020-12-01
|
Series: | Journal of Clinical Medicine |
Subjects: | |
Online Access: | https://www.mdpi.com/2077-0383/9/12/4108 |
id |
doaj-edfda7be87ec4c53a7f42a6edae45910 |
---|---|
record_format |
Article |
spelling |
doaj-edfda7be87ec4c53a7f42a6edae459102020-12-20T00:02:56ZengMDPI AGJournal of Clinical Medicine2077-03832020-12-0194108410810.3390/jcm9124108The Influence of Sex on Clinical Outcomes after Surgical Mitral Valve Replacement in Spain (2001–2015)Nuria Muñoz-Rivas0Ana López-de-Andrés1Manuel Méndez-Bailón2Emmanuel Andrès3Valentín Hernández-Barrera4José María de Miguel-Yanes5Javier de Miguel-Díez6Noel Lorenzo-Villalba7Rodrigo Jiménez-García8Internal Medicine Department, Hospital Universitario Infanta Leonor, 28031 Madrid, SpainDepartment of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, SpainInternal Medicine Department, Hospital Universitario Clínico San Carlos, Universidad Complutense de Madrid, 28040 Madrid, SpainService de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, FranceDepartment of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, SpainInternal Medicine Department, Hospital General Gregorio Marañon, 28007 Madrid, SpainRespiratory Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, SpainService de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, FranceDepartment of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain(1) Background: Mitral regurgitation (MR) is the second most prevalent valvular heart disease in developed countries. Mitral valve (MV) disease is a common cause of heart failure and a leading cause of morbidity and mortality in the U.S.A. and Europe. (2) Methods: We performed a retrospective study using the Spanish National Hospital Discharge Database, 2001–2015. We included patients that had surgical mitral valve replacement (SMVR) listed as a procedure in their discharge report. We sought to (i) examine trends in incidence of SMVR among women and men in Spain, (ii) compare in-hospital outcomes for mechanical and bioprosthetic SMVR by sex, and (iii) identify factors associated with in-hospital mortality (IHM) after SMVR. (3) Results: We identified 44,340 hospitalizations for SMVR (84% mechanical, 16% bioprosthetic). The incidence of SMVR was higher in women (IRR 1.51; 95% CI 1.48–1.54). The use of mechanical SMVR decreased over time in both sexes and the use of bioprosthetic valves increased over time in both sexes. Men who underwent mechanical and bioprosthetic SMVR had higher comorbidity than women. IHM was significantly lower in women who underwent SMVR than in men (10% vs. 12% <i>p</i> < 0.001 for mechanical and 14% vs. 16% <i>p</i> = 0.025 for bioprosthetic valve, respectively). Major adverse cardiovascular and cerebrovascular events (MACCE) were also significantly lower in women who underwent mechanical and bioprosthetic SMVR. A significant reduction in both in-hospital MACCEs and IHM was observed over the study period regardless of sex. After multivariable logistic regression, male sex was associated with increased IHM only in bioprosthetic SMVR (OR 1.28; 95% CI 1.1–1.5). (4) Conclusions: This nationwide analysis over 15 years of sex-specific outcomes after SMVR showed that incidences are significantly higher in women than men for mechanical and bioprosthetic SMVR. IHM and MACCE have improved over time for SMVR in both sexes. Male sex was independently associated with higher mortality after bioprosthetic SMVR.https://www.mdpi.com/2077-0383/9/12/4108sexhospital admissionsmitral valve replacement surgeryin-hospital mortality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nuria Muñoz-Rivas Ana López-de-Andrés Manuel Méndez-Bailón Emmanuel Andrès Valentín Hernández-Barrera José María de Miguel-Yanes Javier de Miguel-Díez Noel Lorenzo-Villalba Rodrigo Jiménez-García |
spellingShingle |
Nuria Muñoz-Rivas Ana López-de-Andrés Manuel Méndez-Bailón Emmanuel Andrès Valentín Hernández-Barrera José María de Miguel-Yanes Javier de Miguel-Díez Noel Lorenzo-Villalba Rodrigo Jiménez-García The Influence of Sex on Clinical Outcomes after Surgical Mitral Valve Replacement in Spain (2001–2015) Journal of Clinical Medicine sex hospital admissions mitral valve replacement surgery in-hospital mortality |
author_facet |
Nuria Muñoz-Rivas Ana López-de-Andrés Manuel Méndez-Bailón Emmanuel Andrès Valentín Hernández-Barrera José María de Miguel-Yanes Javier de Miguel-Díez Noel Lorenzo-Villalba Rodrigo Jiménez-García |
author_sort |
Nuria Muñoz-Rivas |
title |
The Influence of Sex on Clinical Outcomes after Surgical Mitral Valve Replacement in Spain (2001–2015) |
title_short |
The Influence of Sex on Clinical Outcomes after Surgical Mitral Valve Replacement in Spain (2001–2015) |
title_full |
The Influence of Sex on Clinical Outcomes after Surgical Mitral Valve Replacement in Spain (2001–2015) |
title_fullStr |
The Influence of Sex on Clinical Outcomes after Surgical Mitral Valve Replacement in Spain (2001–2015) |
title_full_unstemmed |
The Influence of Sex on Clinical Outcomes after Surgical Mitral Valve Replacement in Spain (2001–2015) |
title_sort |
influence of sex on clinical outcomes after surgical mitral valve replacement in spain (2001–2015) |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2020-12-01 |
description |
(1) Background: Mitral regurgitation (MR) is the second most prevalent valvular heart disease in developed countries. Mitral valve (MV) disease is a common cause of heart failure and a leading cause of morbidity and mortality in the U.S.A. and Europe. (2) Methods: We performed a retrospective study using the Spanish National Hospital Discharge Database, 2001–2015. We included patients that had surgical mitral valve replacement (SMVR) listed as a procedure in their discharge report. We sought to (i) examine trends in incidence of SMVR among women and men in Spain, (ii) compare in-hospital outcomes for mechanical and bioprosthetic SMVR by sex, and (iii) identify factors associated with in-hospital mortality (IHM) after SMVR. (3) Results: We identified 44,340 hospitalizations for SMVR (84% mechanical, 16% bioprosthetic). The incidence of SMVR was higher in women (IRR 1.51; 95% CI 1.48–1.54). The use of mechanical SMVR decreased over time in both sexes and the use of bioprosthetic valves increased over time in both sexes. Men who underwent mechanical and bioprosthetic SMVR had higher comorbidity than women. IHM was significantly lower in women who underwent SMVR than in men (10% vs. 12% <i>p</i> < 0.001 for mechanical and 14% vs. 16% <i>p</i> = 0.025 for bioprosthetic valve, respectively). Major adverse cardiovascular and cerebrovascular events (MACCE) were also significantly lower in women who underwent mechanical and bioprosthetic SMVR. A significant reduction in both in-hospital MACCEs and IHM was observed over the study period regardless of sex. After multivariable logistic regression, male sex was associated with increased IHM only in bioprosthetic SMVR (OR 1.28; 95% CI 1.1–1.5). (4) Conclusions: This nationwide analysis over 15 years of sex-specific outcomes after SMVR showed that incidences are significantly higher in women than men for mechanical and bioprosthetic SMVR. IHM and MACCE have improved over time for SMVR in both sexes. Male sex was independently associated with higher mortality after bioprosthetic SMVR. |
topic |
sex hospital admissions mitral valve replacement surgery in-hospital mortality |
url |
https://www.mdpi.com/2077-0383/9/12/4108 |
work_keys_str_mv |
AT nuriamunozrivas theinfluenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT analopezdeandres theinfluenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT manuelmendezbailon theinfluenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT emmanuelandres theinfluenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT valentinhernandezbarrera theinfluenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT josemariademiguelyanes theinfluenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT javierdemigueldiez theinfluenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT noellorenzovillalba theinfluenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT rodrigojimenezgarcia theinfluenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT nuriamunozrivas influenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT analopezdeandres influenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT manuelmendezbailon influenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT emmanuelandres influenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT valentinhernandezbarrera influenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT josemariademiguelyanes influenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT javierdemigueldiez influenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT noellorenzovillalba influenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 AT rodrigojimenezgarcia influenceofsexonclinicaloutcomesaftersurgicalmitralvalvereplacementinspain20012015 |
_version_ |
1724377344723910656 |