Heart failure & cardiomyopathies
Ventricular Remodeling and Outcomes After Mitral Transcatheter Edge-to-Edge Repair in Heart Failure: The COAPT Trial
Primary result · CV death, per 10 mL/m² decrease in LV end-diastolic volume index at 6 monthsResult — go to the resultAdjusted hazard ratio 0.90 95% CI 0.81–1.00Authors' conclusion
In patients with HF and severe MR, LV reverse remodeling at 6 months was associated with subsequently improved 2-year outcomes but was not affected by TEER or the extent of residual MR.
Study context
- Population
- Patients with heart failure (HF) and severe mitral regurgitation (MR) symptomatic on guideline-directed medical therapy (GDMT)analytical cohort
- Participants
- 348 patients
- Comparison
- Transcatheter edge-to-edge repair (TEER) vs GDMT alone
- TEERn = 190
- GDMT alonen = 158reference
- Primary endpoint
- Association of change in LV volumes (baseline to 6 months) with clinical outcomes from 6 months to 2 years
- Follow-up
- 6 months to 2 years
Methodological detailscore laboratory, multivariable regression
- Core laboratory
- Multivariable regression
Primary result
As reported in the abstract
CV death, per 10 mL/m² decrease in LV end-diastolic volume index at 6 months
Adjusted hazard ratio
0.90
95% CI 0.81–1.00
P = 0.04
Decrease in LV end-diastolic volume index
adjusted HR 0.90 (95% CI 0.81–1.00); P = 0.04
Per 10 mL/m² decrease, as printed
Further findings
All-cause death, HF hospitalization; Left ventricular (LV) end-systolic volume index and all outcomes
- Directionally similar but nonsignificant relationships
LV remodeling at 6 or 12 months by treatment group or 30-day MR severity
- Neither treatment group nor MR severity at 30 days associated with LV remodeling
Treatment benefit of TEER by degree of LV remodeling at 6 months
- TEER benefits not significant regardless of degree of LV remodeling
Original publication
Ventricular Remodeling and Outcomes After Mitral Transcatheter Edge-to-Edge Repair in Heart Failure: The COAPT Trial. JACC Cardiovasc Interv. Published 22 May 2023. doi:10.
Summarised from the published abstract; every number is checked against it