Heart failure & cardiomyopathiesSecondary analysis
Mitral regurgitation in patients with heart failure and reduced ejection fraction: insights from GALACTIC-HF
- Secondary analysis of the GALACTIC-HF randomised trial
Authors' conclusion
In GALACTIC-HF, almost 15% of patients with heart failure and reduced ejection fraction had moderate MR, which was associated with a higher risk of the primary outcome.
Study context
- Population
- Patients with HFrEF in the GALACTIC-HF trial (omecamtiv mecarbil vs placebo)with baseline mitral regurgitation (MR) data
- Participants
- 7,998 patients
- Comparison
- Moderate MR vs no MR
- No MRn = 5,782reference
- Mild MRn = 970
- Moderate MRn = 1,221
- Primary endpoint
- Composite of:
- First HF event
- CV death
Primary result
Primary outcome:
Adjusted hazard ratio
1.11
95% CI 1.01–1.23
Events by treatment group
Moderate MR vs No MR
adjusted HR 1.11 (95% CI 1.01–1.23)
As reported in the abstract
Further findings
Moderate MR and primary outcome, by HF severity (subgroup)
- Association most prominent in less severe HF (milder NYHA class, higher LVEF, lower NT-proBNP)
Mortality
- MR not associated with mortality in adjusted analyses
Omecamtiv mecarbil treatment effect by MR
- Beneficial treatment effect not modified by MR
Eligibility for COAPT and RESHAPE-HF2 (moderate/severe MR)
- Fulfilled broad inclusion criteria
- Over 80%
Original publication
Mitral regurgitation in patients with heart failure and reduced ejection fraction: insights from GALACTIC-HF. Eur J Heart Fail. Published 14 January 2026. doi:10.1093/ejhf/xuag007
Summarised from the published abstract; every number is checked against it