Valvular & structural heart diseaseSecondary analysis
Left Atrial Improvement in Patients With Secondary Mitral Regurgitation and Heart Failure
- Secondary analysis of the COAPT randomised trial
Authors' conclusion
In symptomatic HF patients with severe mitral regurgitation, improved LA strain at the 6-month follow-up is associated with subsequently lower rates of the composite endpoint of all-cause mortality or HFH, both after TEER and GDMT alone.
Study context
- Population
- Symptomatic heart failure (HF) patients with secondary (functional) mitral regurgitation in the COAPT trial (transcatheter edge-to-edge repair (TEER) + GDMT or GDMT alone)
- Participants
- 347 patients
- Comparison
- Left atrial (LA) strain improvers vs non-improvers 6 months after TEER or GDMT alone
- LA strain improversn = 106
- Primary endpoint
- Primary composite endpoint:
- Death
- Heart failure hospitalization (HFH)
- Follow-up
- between the 6-month and 24-month follow-up
Primary result
As reported in the abstract
Death or HFH · 6 to 24 months
Each group vs non-improversAdjusted hazard ratio (95% CI)P value
LA strain improversdichotomous variable
0.49(0.27–0.89)
P = 0.02LA strain improvementcontinuous variable
0.94(0.89–1.00)
P = 0.03- Similar risk reduction in both treatment arms
- P for interaction = 0.27
Further findings
LA strain improvers by treatment arm · 6 months
- LA strain improvers by treatment arm: proportions of the 106 improvers
Original publication
Left Atrial Improvement in Patients With Secondary Mitral Regurgitation and Heart Failure. JACC Cardiovasc Imaging. Published 22 May 2024. doi:10.1016/j.jcmg.2024.03.016
Summarised from the published abstract; every number is checked against it