Sex-Related Differences in Outcomes and Thresholds for Intervention in Primary Mitral Regurgitation: A Systematic Review and Meta-Analysis.
JACC Cardiovasc ImagingJul 10, 2026 (epub)
Clinical ResearchCardiology
Edouard Long, Rebecca T Hahn, Martha Gulati et al.
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In 30 seconds
This systematic review and meta-analysis examined sex-related differences in outcomes following interventions for primary mitral regurgitation (PMR) in 25,690 patients. Women, who were older and had more heart failure symptoms, experienced a significantly higher risk of all-cause mortality compared to men (HR: 1.15; 95% CI: 1.07-1.24) over a follow-up of 15.7 years.
Key findings
- Women had a 5.8-month survival deficit compared to men after PMR intervention.
- Female sex was associated with a 37% increased risk of major adverse cardiovascular events (HR: 1.37; 95% CI: 1.11-1.70).
- Older age and higher prevalence of ≥ moderate tricuspid regurgitation were significant moderators of sex differences in mortality.
Why it matters
Understanding sex differences in outcomes after PMR interventions is crucial for tailoring treatment strategies and ensuring equitable healthcare. This study highlights the need for clinicians to consider these differences when evaluating patient risks and treatment options.