Valvular & structural heart disease

Transcatheter Edge-to-Edge Repair in COAPT-Ineligible Patients With Functional Mitral Regurgitation

J Am Coll CardiolPublished Registry-based cohort study

Main finding · Death or HFHResult — go to the resultHazard ratio 1.73 95% CI 1.57–1.91

Authors' conclusion

Among patients who underwent MTEER for FMR in the TVT Registry, nearly one-half would have been ineligible for the COAPT trial. Health status improvement at 30 days was similar in COAPT-ineligible and COAPT-eligible patients, but trial-ineligible patients had higher 1-year rates of death or HFH.

Study context

Population
Patients undergoing mitral valve transcatheter edge-to-edge repair (MTEER) for functional mitral regurgitation, TVT Registry, 2013–2020
Participants
6,675 patients
Exposure
COAPT-ineligible vs COAPT-eligible patients undergoing MTEER
  • Trial-ineligiblen = 2,954
  • Trial-eligiblen = 3,721reference
Outcome
Death or HF hospitalization (heart failure hospitalization (HFH))
Follow-up
1 year
Methodological detailsmultivariable models
  • Multivariable models

Main finding

Death or HFH

Hazard ratio

1.73

95% CI 1.57–1.91

P < 0.001

Trial-ineligible vs Trial-eligible
HR 1.73 (95% CI 1.57–1.91); P < 0.001

As reported in the abstract

Observational data: associations, not effects.

Further findings

Technical procedural success

Clinically meaningful improvement in health status · 30 days

  • Technical procedural success: P < 0.001

Safety

In-hospital complications

  • In-hospital complications: P < 0.001

Original publication

Transcatheter Edge-to-Edge Repair in COAPT-Ineligible Patients With Functional Mitral Regurgitation. J Am Coll Cardiol. Published 30 January 2024. doi:10.1016/j.jacc.2023.11.012

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

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