Higuchi, Satoshi ORCID: 0000-0002-7914-8256, Orban, Mathias, Adamo, Marianna, Giannini, Cristina, Melica, Bruno, Karam, Nicole ORCID: 0000-0002-3861-6914, Praz, Fabien, Kalbacher, Daniel, Koell, Benedikt, Stolz, Lukas, Braun, Daniel, Naebauer, Michael, Wild, Mirjam, Doldi, Philipp, Neuss, Michael, Butter, Christian, Kassar, Mohammad ORCID: 0000-0002-7576-2224, Ruf, Tobias, Petrescu, Aniela, Ludwig, Sebastian, Pfister, Roman, Iliadis, Christos, Unterhuber, Matthias ORCID: 0000-0002-8175-276X, Sampaio, Francisco, Ferreira, Diogo ORCID: 0000-0003-1428-1651, Thiele, Holger, Baldus, Stephan, von Bardeleben, Ralph Stephan, Massberg, Steffen, Windecker, Stephan, Lurz, Philipp, Petronio, Anna Sonia, Lindenfeld, JoAnn, Abraham, William T., Metra, Marco and Hausleiter, Joeg (2022). Guideline-directed medical therapy in patients undergoing transcatheter edge-to-edge repair for secondary mitral regurgitation. Eur. J. Heart Fail., 24 (11). S. 2152 - 2162. HOBOKEN: WILEY. ISSN 1879-0844

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Abstract

Aims Guideline-directed medical therapy (GDMT), based on the combination of beta-blockers (BB), renin-angiotensin system inhibitors (RASI), and mineralocorticoid receptor antagonists (MRA), is known to have a major impact on the outcome of patients with heart failure with reduced ejection fraction (HFrEF). Although GDMT is recommended prior to mitral valve transcatheter edge-to-edge repair (M-TEER), not all patients tolerate it. We studied the association of GDMT prescription with survival in HFrEF patients undergoing M-TEER for secondary mitral regurgitation (SMR). Methods and results EuroSMR, a European multicentre registry, included SMR patients with left ventricular ejection fraction <50%. The outcome was 2-year all-cause mortality. Of 1344 patients, BB, RASI, and MRA were prescribed in 1169 (87%), 1012 (75%), and 765 (57%) patients at the time of M-TEER, respectively. Triple GDMT prescription was associated with a lower 2-year all-cause mortality compared to non-triple GDMT (hazard ratio [HR] 0.74; 95% confidence interval [CI] 0.60-0.91). The association persisted in patients with glomerular filtration rate <30 ml/min, ischaemic aetiology, or right ventricular dysfunction. Further, a positive impact of triple GDMT prescription on survival was observed in patients with residual mitral regurgitation of >= 2+ (HR 0.62; 95% CI 0.44-0.86), but not in patients with residual mitral regurgitation of <= 1+ (HR 0.83; 95% CI 0.64-1.08). Conclusion Triple GDMT prescription is associated with higher 2-year survival after M-TEER in HFrEF patients with SMR. This association was consistent also in patients with major comorbidities or non-optimal results after M-TEER. [GRAPHICS] .

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Higuchi, SatoshiUNSPECIFIEDorcid.org/0000-0002-7914-8256UNSPECIFIED
Orban, MathiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Adamo, MariannaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Giannini, CristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Melica, BrunoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Karam, NicoleUNSPECIFIEDorcid.org/0000-0002-3861-6914UNSPECIFIED
Praz, FabienUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kalbacher, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koell, BenediktUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stolz, LukasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Braun, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Naebauer, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wild, MirjamUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doldi, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Neuss, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Butter, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kassar, MohammadUNSPECIFIEDorcid.org/0000-0002-7576-2224UNSPECIFIED
Ruf, TobiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Petrescu, AnielaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ludwig, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pfister, RomanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Iliadis, ChristosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Unterhuber, MatthiasUNSPECIFIEDorcid.org/0000-0002-8175-276XUNSPECIFIED
Sampaio, FranciscoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ferreira, DiogoUNSPECIFIEDorcid.org/0000-0003-1428-1651UNSPECIFIED
Thiele, HolgerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baldus, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Bardeleben, Ralph StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Massberg, SteffenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Windecker, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lurz, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Petronio, Anna SoniaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lindenfeld, JoAnnUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Abraham, William T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Metra, MarcoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hausleiter, JoegUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-695733
DOI: 10.1002/ejhf.2613
Journal or Publication Title: Eur. J. Heart Fail.
Volume: 24
Number: 11
Page Range: S. 2152 - 2162
Date: 2022
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1879-0844
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
HEART-FAILUREMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69573

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