Valvular & structural heart diseaseSecondary analysis
Impact of Heart Failure Hospitalizations on Clinical Outcomes After Mitral Transcatheter Edge-to-Edge Repair: Results from the EXPAND Study
- Secondary analysis of the EXPAND study
- global
- real-world
- independent echocardiographic core laboratory
Authors' conclusion
Results demonstrate that the occurrence of HFH was associated with worse 1-year survival, and treatment with the MitraClip system substantially reduced HFH and improved patient symptoms and quality of life.
Study context
- Population
- Patients with primary or secondary mitral regurgitation (MR) treated with the MitraClip NTR/XTR System
- Participants
- 1,041 patients
- Comparison
- HF hospitalizations (HFH) vs No-HFH within 1 year after MitraClip M-TEER
- HFHn = 181
- No-HFHn = 860reference
- Primary endpoint
- Clinical outcomes (MR severity, NYHA class, Kansas City Cardiomyopathy Questionnaire (KCCQ) score, all-cause mortality) by HFH occurrence
- Follow-up
- 1 year
Primary result
As reported in the abstract
All-cause mortality
P < 0.001
Further findings
MR reduction to ≤1+ · 1 year
P = 0.6
NYHA class ≤II · 1 year
P < 0.01
| Outcome | HFH | No-HFH | relative risk | P value |
|---|---|---|---|---|
| KCCQ score improvement · 1 year | +16.5 | +22.3 | P = 0.09 | |
| HFH rate, 1 year post-M-TEER vs 1 year pre-treatment · HFH rate decreased by 63% | 0.4 | P < 0.001 |
Independent HFH associations
- MR ≥2+ at discharge, HFH 1 year prior to treatment, baseline New York Heart Association (NYHA) class ≥III, baseline tricuspid regurgitation ≥2+, baseline LVEF ≤40%
Original publication
Impact of Heart Failure Hospitalizations on Clinical Outcomes After Mitral Transcatheter Edge-to-Edge Repair: Results from the EXPAND Study. Eur J Heart Fail. Published 10 May 2024. doi:10.1002/ejhf.3250
Summarised from the published abstract; every number is checked against it