Valvular & structural heart disease
How the COAPT trial affected the selection of patients with secondary mitral regurgitation undergoing transcatheter edge-to-edge repair: insights from the GIOTTO registry
Authors' conclusion
The selection process of SMR patients undergoing MC changed over time, with a significant impact of the COAPT publication mainly on the trend of NYHA class. At 1-year, patients in the post-COAPT group showed a nonsignificant reduction in the incidence of hospitalization for HF and all-cause death.
Study context
- Population
- Secondary mitral regurgitation (SMR) patients treated with MitraClip (MC) in the GIOTTO registry, January 2016 to March 2020consecutive SMR patients treated with MC at 19 Italian centres
- Participants
- 1,184 participants
- Exposure
- Enrolment before or after the COAPT publication
- pre-COAPT groupn = 809 (68.3%)
- post-COAPT groupn = 375 (31.7%)
- Outcome
- Temporal trends in baseline characteristics
Methodological detailsconsecutive patients, 19 Italian centres, temporal trend analyses
- Consecutive patients
- 19 Italian centres
- Temporal trend analyses
Main finding
As reported in the abstract
- Decreasing trend for New York Heart Association (NYHA) class
- P = .003
- Decreasing trend for hemoglobin
- P = .014
- Significant upward trend for left ventricular ejection fraction
- P < .001
- Significant upward trend for peripheral arterial disease (PAD)
- P = .046
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Composite of hospitalization for heart failure (HF) and all-cause death · 1 yearNonsignificant differences | P = 0.086 |
Original publication
How the COAPT trial affected the selection of patients with secondary mitral regurgitation undergoing transcatheter edge-to-edge repair: insights from the GIOTTO registry. Am Heart J. Published 27 January 2025. doi:10.
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