Valvular & structural heart diseaseSecondary analysis
Impact of Malnutrition in Patients With Heart Failure and Secondary Mitral Regurgitation
- Secondary analysis of the COAPT randomised trial
Authors' conclusion
Malnutrition was present in 1 of 6 patients with HF and severe SMR enrolled in COAPT and was independently associated with increased 4-year mortality (but not HFH). TEER reduced mortality and HFH in patients with and without malnutrition.
Study context
- Population
- Heart failure (HF) patients with severe secondary mitral regurgitation randomised to transcatheter edge-to-edge repair (TEER) with MitraClip plus guideline-directed medical therapy (GDMT) vs GDMT alone
- Participants
- 552 patients
- Comparison
- Malnutrition vs no malnutrition
- Malnutritionn = 94
- Primary endpoint
- All-cause mortality
- Follow-up
- 4 years
Primary result
As reported in the abstract
Adj-HR
1.37
95% CI 1.03–1.82
P = 0.03
By group
Malnutrition vs No malnutrition
adj-HR 1.37 (95% CI 1.03–1.82); P = 0.03
Further findings
| Outcome | adj-HR (95% CI) | P value | |
|---|---|---|---|
| 4-year mortality, TEER plus GDMT vs GDMT alone · multivariable | 0.65 (0.51–0.82) | P = 0.0003 | |
| HF hospitalisation · 4 years | 0.46 (0.36–0.56) | ||
| 0.20.5125Adj-hr (log scale) |
- 4-year mortality, TEER plus GDMT vs GDMT alone: consistent with and without malnutrition, adj-Pinteraction = 0.46
- HF hospitalisation: consistent with and without malnutrition, adj-Pinteraction = 0.67
Prevalence of malnutrition and baseline geriatric nutritional risk index (GNRI) · median Baseline
- Malnutrition
- 94 (17.0%)
- Median baseline GNRI
- 109 (IQR: 101-116)
HF hospitalisation · 4 years
- GNRI unrelated to 4-year heart failure hospitalization (HFH) rate
Original publication
Impact of Malnutrition in Patients With Heart Failure and Secondary Mitral Regurgitation. J Am Coll Cardiol. Published 9 June 2023. doi:10.1016/j.jacc.2023.04.047
Summarised from the published abstract; every number is checked against it