Abstract

Background: Palestinians in the Jerusalem district in Israel have been shown to present poorer healthcare utilization patterns and worse health outcomes in a wide variety of clinical domains. Transcatheter Edge-to-Edge Repair (TEER) for Mitral Regurgitation (MR) has been established as an alternative to surgical mitral valve in patients with prohibitive surgical risk. Objective: This study aimed to compare the outcomes of TEER for MR among both the Palestinian and Jewish population in Jerusalem. Methods: A retrospective analysis of prospectively collected data in TEER registry in the Jerusalem district. We compared clinical characteristics and outcomes by ethnicity. Results: Our study included 324 patients who had undergone TEER, of whom 57 were Palestinian (17.59%). Palestinian patients were significantly younger (66.34 ± 10.45 years vs. 78.75 ±9.18 years, respectively, P<0.001) and tended to have more cardiovascular comorbidities and more hospital admissions in the last year. Importantly, the Palestinian patients had a higher proportion of ejection fraction<40% (61.40% vs 41.95%, P<0.001) and as more functional MR (70.18% vs 63.88 %, P=0.36). In addition, more Palestinians requires urgent mitral intervention (26.79% vs 11.41%, P<0.001). There was no difference in major complications (and 3.51% vs 3.00%, P=0.83 respectively). Although Palestinian were 10 years younger when compared with Jewish patients, mortality rates were similar (5.26% vs. 3.75%, P=0.59 for 30 days and 15.69% vs. 16.10%, P=0.69 for one-year, respectively). Conclusions: Palestinian patients in this study were younger had more comorbidities that required urgent intervention. Further clinical research is address ethnic differences and gaps in therapy.

Keywords: Mitral regurgitation; Transcatheter edge-to-edge repair; Ethnicity; Palestinians; Jewish; Jews