Heart failure & cardiomyopathies
Regurgitant volume to LA volume ratio in patients with secondary mitral regurgitation (MR): the COAPT trial
Primary result · HF hospitalization by RVol/LAV ratioResult — go to the resultAdjusted hazard ratio 1.77 95% CI 1.20–2.63Authors' conclusion
Low RVol/LAV ratio was an independent predictor of 2-year HFH in HF patients with severe MR treated with GDMT alone in the COAPT trial. TEER improved outcomes regardless of baseline RVol/LAV ratio.
Study context
- Population
- Heart failure (HF) patients with severe secondary MR
- Participants
- 567 patients
- Comparison
- Transcatheter edge-to-edge repair (TEER) plus guideline-directed medical therapy (GDMT) vs GDMT alone, by baseline regurgitant volume (RVol)/left atrial volume (LAV) ratio
- Primary endpoint
- Covariate-adjusted rate of HF hospitalization
- Follow-up
- 2 years
Primary result
HF hospitalization by RVol/LAV ratio
Adjusted hazard ratio
1.77
95% CI 1.20–2.63
TEER (MitraClip) plus GDMT vs GDMT alone, by baseline RVol/LAV ratio
adjHR 1.77 (95% CI 1.20–2.63)
As reported in the abstract
- TEER plus GDMT vs GDMT alone associated with lower 2-year HF hospitalization (HFH) in both low and high RVol/LAV
- P for interaction = 0.28
Further findings
Baseline RVol/LAV
- Median RVol/LAV (IQR 0.48-0.91)
- 0.67
Mortality, health status, functional capacity · 2 years
- Baseline RVol/LAV unrelated to 2-year mortality, health status or functional capacity in either treatment group
Original publication
Regurgitant volume to LA volume ratio in patients with secondary MR: the COAPT trial. Eur Heart J Cardiovasc Imaging. Published 7 December 2023. doi:10.
Summarised from the published abstract; every number is checked against it