PMID- 31146872
OWN - NLM
STAT- MEDLINE
DCOM- 20201013
LR  - 20210109
IS  - 2213-1787 (Electronic)
IS  - 2213-1779 (Print)
IS  - 2213-1779 (Linking)
VI  - 7
IP  - 6
DP  - 2019 Jun
TI  - Sex-Based Differences in Outcomes After Mitral Valve Surgery for Severe Ischemic 
      Mitral Regurgitation: From the Cardiothoracic Surgical Trials Network.
PG  - 481-490
LID - S2213-1779(19)30151-9 [pii]
LID - 10.1016/j.jchf.2019.03.001 [doi]
AB  - OBJECTIVES: This study investigated sex-based differences in outcomes after 
      mitral valve (MV) surgery for severe ischemic mitral regurgitation (SIMR). 
      BACKGROUND: Whether differences in outcomes exist between men and women after 
      surgery for SIMR remains unknown. METHODS: Patients enrolled in a randomized 
      trial comparing MV replacement versus MV repair for SIMR were included and 
      followed for 2 years. Endpoints for this analysis included all-cause mortality, 
      major adverse cardiovascular and cerebrovascular events (MACCE) (defined as the 
      composite of death, stroke, hospitalization for heart failure, worsening New York 
      Heart Association functional class or MV re-operation), quality of life (QOL), 
      functional status, and percentage of change in left ventricular end-systolic 
      volume index (LVESVI) from baseline through 2 years. RESULTS: Of 251 patients 
      enrolled in the trial, 96 (38.2%) were women. Compared with men, women had 
      smaller LV volumes and effective regurgitant orifice areas (EROA) but greater 
      EROA/left ventricular (LV) end-diastolic volume ratios. At 2 years, women had 
      higher rates of all-cause mortality (27.1% vs. 17.4%, respectively; adjusted 
      hazard ratio [adjHR]: 1.85; 95% confidence interval [CI]: 1.05 to 3.26; p = 0.03) 
      and of MACCE (49.0% vs. 38.1%, respectively; adjHR: 1.58; 95% CI: 1.06 to 2.37; 
      p = 0.02). Women also reported worse QOL and functional status at 2 years. There 
      were no significant differences in the percentage of change over 2 years in 
      LVESVI between women and men (adjbeta: -10.4; 95% CI: -23.4 to 2.6; p = 0.12). 
      CONCLUSIONS: Women with SIMR displayed different echocardiographic features and 
      experienced higher mortality and worse QOL after MV surgery than men. There were 
      no significant differences in the degree of reverse LV remodeling between sexes. 
      (Comparing the Effectiveness of Repairing Versus Replacing the Heart's Mitral 
      Valve in People With Severe Chronic Ischemic Mitral Regurgitation [Severe 
      Ischemic Mitral Regurgitation]; NCT00807040).
CI  - Copyright (c) 2019 American College of Cardiology Foundation. All rights reserved.
FAU - Giustino, Gennaro
AU  - Giustino G
AD  - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine 
      at Mount Sinai, New York, New York; Department of Population Health Science and 
      Policy, Icahn School of Medicine at Mount Sinai, New York, New York.
FAU - Overbey, Jessica
AU  - Overbey J
AD  - Department of Population Health Science and Policy, Icahn School of Medicine at 
      Mount Sinai, New York, New York.
FAU - Taylor, Doris
AU  - Taylor D
AD  - Department of Regenerative Medicine Research, Texas Heart Institute, Houston, 
      Texas.
FAU - Ailawadi, Gorav
AU  - Ailawadi G
AD  - Division of Thoracic and Cardiovascular Surgery, University of Virginia, 
      Charlottesville, Virginia.
FAU - Kirkwood, Katherine
AU  - Kirkwood K
AD  - Department of Population Health Science and Policy, Icahn School of Medicine at 
      Mount Sinai, New York, New York.
FAU - DeRose, Joseph
AU  - DeRose J
AD  - Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, 
      Albert Einstein College of Medicine, Bronx, New York.
FAU - Gillinov, Marc A
AU  - Gillinov MA
AD  - Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, 
      Cleveland Clinic, Cleveland, Ohio.
FAU - Dagenais, Francois
AU  - Dagenais F
AD  - Institut Universitaire de Cardiologie et de Pneumologie de Quebec/Quebec Heart 
      and Lung Institute, Laval University, Quebec City, Quebec, Canada.
FAU - Mayer, Mary-Lou
AU  - Mayer ML
AD  - Department of Surgery, Division of Cardiovascular Surgery, University of 
      Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
FAU - Moskowitz, Alan
AU  - Moskowitz A
AD  - Department of Population Health Science and Policy, Icahn School of Medicine at 
      Mount Sinai, New York, New York.
FAU - Bagiella, Emilia
AU  - Bagiella E
AD  - Department of Population Health Science and Policy, Icahn School of Medicine at 
      Mount Sinai, New York, New York.
FAU - Miller, Marissa
AU  - Miller M
AD  - National Heart, Lung, and Blood Institute of the National Institutes of Health, 
      Bethesda, Maryland.
FAU - Grayburn, Paul
AU  - Grayburn P
AD  - Division of Cardiology, Department of Internal Medicine, Baylor University 
      Medical Center, Dallas, Texas.
FAU - Smith, Peter K
AU  - Smith PK
AD  - Division of Cardiothoracic Surgery, Department of Surgery, Duke University, 
      Durham, North Carolina.
FAU - Gelijns, Annetine
AU  - Gelijns A
AD  - Department of Population Health Science and Policy, Icahn School of Medicine at 
      Mount Sinai, New York, New York. Electronic address: Annetine.gelijns@mssm.edu.
FAU - O'Gara, Patrick
AU  - O'Gara P
AD  - Division of Cardiology, Brigham and Women's' Hospital, Boston, Massachusetts.
FAU - Acker, Michael
AU  - Acker M
AD  - Department of Surgery, Division of Cardiovascular Surgery, University of 
      Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
FAU - Lala, Anuradha
AU  - Lala A
AD  - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine 
      at Mount Sinai, New York, New York; Department of Population Health Science and 
      Policy, Icahn School of Medicine at Mount Sinai, New York, New York.
FAU - Hung, Judy
AU  - Hung J
AD  - Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts.
LA  - eng
SI  - ClinicalTrials.gov/NCT00807040
GR  - U01 HL088942/HL/NHLBI NIH HHS/United States
GR  - CIHR/Canada
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - JACC Heart Fail
JT  - JACC. Heart failure
JID - 101598241
SB  - IM
CIN - JACC Heart Fail. 2019 Jun;7(6):491-492. PMID: 31146873
MH  - Aged
MH  - Cause of Death
MH  - Disease Progression
MH  - Female
MH  - Heart Failure
MH  - *Heart Valve Prosthesis Implantation
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Mitral Valve Annuloplasty
MH  - Mitral Valve Insufficiency/etiology/*surgery
MH  - Mortality
MH  - Myocardial Infarction/*complications/physiopathology
MH  - Myocardial Ischemia/complications/physiopathology
MH  - Quality of Life
MH  - Reoperation
MH  - Severity of Illness Index
MH  - Sex Factors
MH  - Stroke/epidemiology
MH  - Stroke Volume/physiology
MH  - Treatment Outcome
MH  - Ventricular Remodeling/physiology
PMC - PMC6676484
MID - NIHMS1528411
OTO - NOTNLM
OT  - ischemic mitral regurgitation
OT  - mitral valve repair
OT  - mitral valve replacement
OT  - women
EDAT- 2019/05/31 06:00
MHDA- 2020/10/21 06:00
PMCR- 2020/06/01
CRDT- 2019/06/01 06:00
PHST- 2018/12/04 00:00 [received]
PHST- 2019/02/17 00:00 [revised]
PHST- 2019/03/05 00:00 [accepted]
PHST- 2019/06/01 06:00 [entrez]
PHST- 2019/05/31 06:00 [pubmed]
PHST- 2020/10/21 06:00 [medline]
PHST- 2020/06/01 00:00 [pmc-release]
AID - S2213-1779(19)30151-9 [pii]
AID - 10.1016/j.jchf.2019.03.001 [doi]
PST - ppublish
SO  - JACC Heart Fail. 2019 Jun;7(6):481-490. doi: 10.1016/j.jchf.2019.03.001.