Relationship Between Residual Mitral Regurgitation and Clinical and Quality-of-Life Outcomes After Transcatheter and Medical Treatments in Heart Failure: COAPT Trial

• Published in: Circulation (New York, N.Y.) N.Y.), 2021-08, Vol.144 (6), p.426-437
• Main Authors: Kar, Saibal, Mack, Michael J., Lindenfeld, JoAnn, Abraham, William T., Asch, Federico M., Weissman, Neil J., Enriquez-Sarano, Maurice, Lim, D. Scott, Mishell, Jacob M., Whisenant, Brian K., Rogers, Jason H., Arnold, Suzanne V., Cohen, David J., Grayburn, Paul A., Stone, Gregg W.
• Format: Article
• Language: English
• Subjects: Cardiac Catheterization; Heart Failure - diagnosis; Heart Failure - epidemiology; Heart Failure - etiology; Heart Failure - therapy; Heart Valve Prosthesis; Humans; Mitral Valve Insufficiency - complications; Mitral Valve Insufficiency - diagnosis; Mitral Valve Insufficiency - epidemiology; Mitral Valve Insufficiency - therapy; Outcome Assessment, Health Care; Prognosis; Public Health Surveillance; Quality of Life; Randomized Controlled Trials as Topic; Severity of Illness Index; Time Factors
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/CIRCULATIONAHA.120.053061

In the randomized COAPT trial (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation), among 614 patients with heart failure with 3+ or 4+ secondary mitral regurgitation (MR), transcatheter mitral valve repair (TMVr) with the MitraClip reduced MR, heart failure hospitalizations, and mortality and improved quality of life compared with guideline-directed medical therapy (GDMT) alone. We aimed to examine the prognostic relationship between MR reduction and outcomes after TMVr and GDMT alone. Outcomes in COAPT between 30 days and 2 years were examined on the basis of the severity of residual MR at 30 days. TMVr-treated patients had less severe residual MR at 30 days than GDMT-treated patients (0/1+, 2+, and 3+/4+: 72.9%, 19.9%, and 7.2% versus 8.2%, 26.1%, and 65.8%, respectively [