Valvular & structural heart diseaseCohort study
Heart failure medical therapy prior to mitral transcatheter edge-to-edge repair: the STS/ACC Transcatheter Valve Therapy Registry
- Retrospective cohort study
- registry-based
- multicentre
Authors' conclusion
Under one-fifth of patients with LVEF <50% who underwent MTEER for FMR in this US nationwide registry were prescribed comprehensive GDMT, with substantial variation across sites. Compared with no/single therapy, triple and double therapy before MTEER were independently associated with reduced risk of mortality or HFH 1 year after intervention.
Study context
- Population
- Patients with left ventricular ejection fraction (LVEF) <50% undergoing MTEER for functional mitral regurgitation, STS/ACC TVT Registry, 23 July 2019 to 31 March 2022
- Participants
- 4,199 patients · 449 sites
- Exposure
- Pre-MTEER guideline-directed medical therapy (GDMT): triple vs double vs no/single therapy
- Outcome
- Mortality or heart failure (HF) hospitalization
- Follow-up
- 1 year
Main finding
As reported in the abstract
1-year mortality or HF hospitalization (HFH)
aHR
- Triple therapy
- 0.73 (95% CI .55-.97)
- Double therapy
- 0.69 (95% CI .56-.86)
- Across-group difference in unadjusted rates
- P < 0.01
Observational data: associations, not effects.
Further findings
Pre-MTEER GDMT category
Pre-MTEER use by drug class
- Beta-blockers
- 85.1%
- ACEi/ARB
- 44.4%
- MRA
- 28.6%
- ARNI
- 19.9%
Centre-level variation in proportion on pre-intervention triple therapy
- Range across centres
- 0%-61%
- Adjusted median OR 1.48 (95% CI 1.25-3.88)
- P < 0.001
Original publication
Heart failure medical therapy prior to mitral transcatheter edge-to-edge repair: the STS/ACC Transcatheter Valve Therapy Registry. Eur Heart J. Published 26 August 2023. doi:10.1093/eurheartj/ehad584
Summarised from the published abstract; every number is checked against it