Outcomes of Transcatheter Mitral Valve Repair in Patients With Rheumatoid Arthritis – A Retrospective Study from the National Inpatient Sample Database

Introduction: Transcatheter mitral valve repair (TMVR) with the MitraClip device is a widely performed procedure for both primary and secondary mitral regurgitation. Several studies have assessed outcomes of TMVR in subpopulations with different comorbidities. However, there is no data on the safety and outcomes of TMVR in patients with rheumatoid arthritis (RA), which is a known independent risk factor for cardiovascular disease. Methods: We performed a retrospective analysis using data from the Nationwide Inpatient Sample (NIS) database from 2016-2019 to assess the outcomes of TMVR in patients with RA vs. without RA. Our primary outcome was in-hospital mortality following TMVR. Our secondary outcomes included the association of pre-specified comorbidities with in-hospital mortality and rates of post-procedural complications between RA vs. without RA groups. Results: A total of 4,176 patients were included in analysis (85 with RA, 4091 without RA). Our results showed no significant difference in mortality between patients with versus without RA (OR 0.798, p = 0.825). Patients with underlying diabetes had significantly increased mortality following TMVR (OR 1.843, p = 0.027). Patients with underlying CABG had significantly lower mortality following TMVR (OR 0.439, p = 0.047). Multivariate regression analysis of in-hospital complications showed no significant difference in complications between the RA vs. without RA groups. Conclusion: Our data shows no increased risk of in-hospital mortality or complications in patients with RA following TMVR.