Valvular & structural heart diseaseCohort study

Transcatheter Edge-to-Edge Repair in 5,000 Patients With Secondary Mitral Regurgitation

J Am Coll CardiolPublished

  • Prospective observational single-arm study
  • multicentre
  • 406 US centres
  • TVT registry

Authors' conclusion

This large, contemporary, real-world study reinforces the safety and effectiveness of the MitraClip System in patients with SMR, including those who met the COAPT or MITRA-FR RCT inclusion/exclusion criteria and patients excluded from the RCTs.

Study context

Population
Consecutive patients with secondary mitral regurgitation treated with MitraClip at US centres, 2019–2020
Participants
5,000 consecutive patients
Exposure
COAPT-PAS vs COAPT-like vs MITRA-FR-like
  • COAPT-liken = 991
  • MITRA-FR-liken = 917
Outcome
Safety and effectiveness of MitraClip (1-year outcomes)
Follow-up
1 year

Main finding

As reported in the abstract

MR reduction to ≤2+
MitraClip implant rate
97.7%

Observational data: associations, not effects.

Further findings

HF hospitalisation · 1 year

OutcomeCOAPT-PASCOAPT-likeMITRA-FR-like
KCCQ improvement · 1 year+29+27+33
HF hospitalisation — COAPT-RCT
24.9%
HF hospitalisation — MITRA-FR-RCT
47.4%

Clinical event rates vs randomized controlled trial (RCTs)

Similar or lower than the RCTs' MitraClip arms; lower than the RCTs' GDMT-only arms; faster procedure times

Original publication

Transcatheter Edge-to-Edge Repair in 5,000 Patients With Secondary Mitral Regurgitation. J Am Coll Cardiol. Published 26 September 2023. doi:10.1016/j.jacc.2023.07.015

Summarised from the published abstract; every number is checked against it