Valvular & structural heart disease
Impact of Natriuretic Peptide and Prior Hospitalization in Patients With Severe Mitral Regurgitation: COAPT Trial
Authors' conclusion
In patients with HF with severe secondary mitral regurgitation enrolled in the COAPT trial, 2-year rates of death/HFH were increased with an elevated baseline BNP/NT-proBNP≥median, and more so if HFH within 1 year prior had occurred. Treatment with mitral transcatheter edge-to-edge repair reduced all-cause mortality and HFH consistently in mild, moderate, and severe HF.
Study context
- Population
- Patients with heart failure (HF) with severe secondary mitral regurgitation enrolled in the COAPT trial, grouped by baseline BNP/NT-proBNP level and prior heart failure hospitalization (HFH) within 1 year
- Participants
- 572 patients
- Comparison
- Mitral valve transcatheter edge-to-edge repair with the MitraClip device versus guideline-directed medical therapy alone, across HF severity groups defined by BNP/NT-proBNP levels and prior HFH within 1 year
- Mild HFn = 125 (21.9%)
- Moderate HFn = 288 (50.3%)
- Severe HFn = 159 (27.8%)
- Primary endpoint
- Death or HFH
- Follow-up
- 2 years
Primary result
As reported in the abstract
Further findings
Death or HFH among patients with moderate HF: prior HFH only vs elevated BNP/NT-proBNP≥median only (guideline-directed medical therapy alone) · 2 years
P = 0.003
Death/HFH, mitral transcatheter edge-to-edge repair vs guideline-directed medical therapy alone, by HF severity
- Mitral transcatheter edge-to-edge repair reduced death/HFH compared with guideline-directed medical therapy alone regardless of HF severity
- P interaction =0.50
Original publication
Summarised from the published abstract; every number is checked against it