Valvular & structural heart diseaseCohort study
Guideline-Directed Medical Therapy and Survival After TEER for Secondary Mitral Regurgitation With Right Ventricular Impairment
- Registry-based cohort study
- international registry
- propensity-score matched analysis
Authors' conclusion
In patients with right ventricular impairment undergoing transcatheter edge-to-edge repair for SMR, titration of GDMT to at least one-half of the target dose is associated with a 40% lower risk of all-cause death up to 6 years
Study context
- Population
- Patients with secondary mitral regurgitation and RV impairment (TAPSE ≤17 mm and/or RV-to-pulmonary artery coupling <0.40 mm/mm Hg) undergoing transcatheter edge-to-edge repair, EuroSMR registry852 with complete medication data
- Participants
- 1,213 patients
- Exposure
- Titrated guideline-directed medical therapy (GDMT) vs no titrated GDMT after TEER
- GDMTtitn = 123
- Not on GDMTtitn = 729reference
- Outcome
- All-cause mortality
- Follow-up
- Up to 6 years
Main finding
Long-term survival
Hazard ratio
0.61
95% CI 0.39–0.93
P = 0.02
By group
GDMTtit vs Not on GDMTtit
HR 0.61 (95% CI 0.39–0.93); P = 0.02
As reported in the abstract
Observational data: associations, not effects.
Further findings
Survival, propensity score-matched analysis · propensity score-matched
P = 0.018
All-cause mortality, subgroups
- Association with better outcomes confirmed among all subgroups analyzed
Original publication
Guideline-Directed Medical Therapy and Survival After TEER for Secondary Mitral Regurgitation With Right Ventricular Impairment. JACC Cardiovasc Interv. Published 24 June 2024. doi:10.1016/j.jcin.2024.04.025
Summarised from the published abstract; every number is checked against it