Valvular & structural heart disease
Phenotypic Diversity and Outcomes of Transcatheter Mitral Repair for Secondary Mitral Regurgitation: Insights From the COAPT and MITRA-FR Trials
Authors' conclusion
Clustering analysis identified 3 distinct SMR phenotypes that were validated across 2 landmark M-TEER trials.
Study context
- Population
- Patients with secondary mitral regurgitation in the COAPT and MITRA-FR trialsCOAPT
- Participants
- 614 patients
- Comparison
- M-TEER vs no M-TEER across secondary mitral regurgitation (SMR) phenotype clusters
- Primary endpoint
- HF hospitalization or CV death
- Follow-up
- 2 years
Methodological detailsunsupervised hierarchical clustering, external validation in MITRA-FR
- Unsupervised hierarchical clustering
- External validation in MITRA-FR
Primary result
As reported in the abstract
HF hospitalization or CV death with M-TEER, by cluster
HF hospitalization or CV death with M-TEER, by cluster · 2 years
Relative risk reduction
P Cluster 1 P = 0.026 · Cluster 2 P < 0.001 · Cluster 3 P = 0.033
Further findings
Survival benefit of M-TEER, by cluster
- Survival benefit in cluster 1
- P = 0.047
- Survival benefit in cluster 2
- P = 0.018
- No survival benefit in cluster 3
- P = 0.22
2-year survival probability across clusters
- Cluster 1 had the highest 2-year survival probability among the 3 groups
- P < 0.001
Validation in MITRA-FR: cluster 3 prevalence
- Similar findings; cluster 3 more prevalent in MITRA-FR than COAPT
- 48% vs 36%
Original publication
Phenotypic Diversity and Outcomes of Transcatheter Mitral Repair for Secondary Mitral Regurgitation: Insights From the COAPT and MITRA-FR Trials. JACC Cardiovasc Interv. Published 11 May 2026. doi:10.
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