Valvular & structural heart diseaseCohort study
Transcatheter Edge-To-Edge Repair in Severe Mitral Regurgitation Following Acute Myocardial Infarction – Aetiology-Based Analysis
- Registry-based cohort study
- international registry
Authors' conclusion
Transcatheter edge-to-edge repair may be considered a salvage or bridge procedure in decompensated post-MI MR patients of both aetiologies; however, patients with PMR have a higher risk of mortality and conversion to surgery.
Study context
- Population
- High-risk surgical patients with severe mitral regurgitation (MR) after acute myocardial infarction (MI) managed with transcatheter edge-to-edge repair (TEER) (IREMMI registry)176 analysed
- Participants
- 187 patients
- Exposure
- Papillary muscle rupture (PMR) vs secondary MR in patients treated with TEER after acute MI
- PMRn = 23
- Secondary MRn = 153reference
Main finding
In-hospital mortality
Adjusted odds ratio
3.05
95% CI 1.15–8.12
P = 0.02
PMR vs Secondary MR
adjusted OR 3.05 (95% CI 1.15–8.12); P = 0.02
As reported in the abstract
- MR aetiology remained strongest predictor after adjustment for EuroSCORE II and cardiogenic shock
- 6.71; 2.06-21.86, p < 0.01 (adjusted OR; 95% CI)
Observational data: associations, not effects.
Further findings
| Outcome | unadjusted OR (95% CI) | P value | |
|---|---|---|---|
| 30-day mortality | 3.99 (1.42–11.26) | P = 0.01 | |
| Conversion to surgical mitral valve replacement · 22% vs. 3%, p < 0.01 | 8.17 (2.15–30.96) | P < 0.001 | |
| 0.050.21520Unadjusted odds ratio (log scale) |
Procedural success
- Procedural success similar, with comparable MR grade reduction
- 87% vs. 92%, p = 0.49
Original publication
Transcatheter Edge-To-Edge Repair in Severe Mitral Regurgitation Following Acute Myocardial Infarction – Aetiology-Based Analysis. Eur J Heart Fail. Published 14 January 2025. doi:10.1002/ejhf.3582
Summarised from the published abstract; every number is checked against it