Iliadis, Christos, Metze, Clemens, Koerber, Maria Isabel, Baldus, Stephan and Pfister, Roman (2020). Impact of COAPT trial exclusion criteria in real-world patients undergoing transcatheter mitral valve repair. Int. J. Cardiol., 316. S. 189 - 195. CLARE: ELSEVIER IRELAND LTD. ISSN 1874-1754
Full text not available from this repository.Abstract
Background: The generalizability of the COAPT trial results on the benefit of TMVR in patients with secondary mitral regurgitation is unclear. Methods: Functional and long-term clinical outcome were examined in 122 consecutive patients with secondary mitral regurgitation and reduced ejection fraction undergoing TMVR. COAPT-like patients were defined according to principal COAPT inclusion/exclusion criteria if all of the following was fulfilled: symptomatic mitral regurgitation grade 3+ or more according to American guidelines; left ventricular ejection fraction >= 20%, left ventricular end-systolic dimension <= 70 mm, estimated pulmonary artery systolic pressure <= 70 mmHg, mitral valve orifice area >= 4 cm(2), no prior mitral valve procedure, no right sided congestive heart failure, no COPD requiring home oxygen therapy and NYHA class less than IVb. Results: 51% of 122 patients (mean age 74 +/- 10 years, 76% male) showed COAPT-like characteristics. COAPT-like patients showed a significantly lower hazard for the composite endpoint of mortality and heart failure hospitalization (HR 0.51, 95%CI 0.30-0.89, p = .017) during a mean follow-up of 16 +/- 6 months, with an estimated 1-year event rate of 20% vs 43%, respectively. The improvement in functional outcomes 6 min walking distance (76 +/- 136 m vs. 31 +/- 90 m), Minnesota Living with Heart Failure Questionnaire (-6 +/- 19 vs. -10 +/- 23) and Short Form 36 physical component score (3.8 +/- 10 vs. 5.5 +/- 11) was similar in COAPT-like and the other patients. Conclusion: In this first real world cohort half of the patients undergoing TMVR showed COAPT-like characteristics and these patients showed a substantially better clinical outcome. The mid-term functional benefit was similar in COAPT-like and other patients. (C) 2020 Elsevier B.V. All rights reserved.
Item Type: | Journal Article | ||||||||||||||||||||||||
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URN: | urn:nbn:de:hbz:38-316258 | ||||||||||||||||||||||||
DOI: | 10.1016/j.ijcard.2020.05.061 | ||||||||||||||||||||||||
Journal or Publication Title: | Int. J. Cardiol. | ||||||||||||||||||||||||
Volume: | 316 | ||||||||||||||||||||||||
Page Range: | S. 189 - 195 | ||||||||||||||||||||||||
Date: | 2020 | ||||||||||||||||||||||||
Publisher: | ELSEVIER IRELAND LTD | ||||||||||||||||||||||||
Place of Publication: | CLARE | ||||||||||||||||||||||||
ISSN: | 1874-1754 | ||||||||||||||||||||||||
Language: | English | ||||||||||||||||||||||||
Faculty: | Unspecified | ||||||||||||||||||||||||
Divisions: | Unspecified | ||||||||||||||||||||||||
Subjects: | no entry | ||||||||||||||||||||||||
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URI: | http://kups.ub.uni-koeln.de/id/eprint/31625 |
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