Universität zu Köln

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
Creators:	Creators Email ORCID ORCID Put Code Iliadis, Christos UNSPECIFIED UNSPECIFIED UNSPECIFIED Metze, Clemens UNSPECIFIED UNSPECIFIED UNSPECIFIED Koerber, Maria Isabel UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED
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
Uncontrolled Keywords:	Keywords Language REGURGITATION; OUTCOMES; THERAPY; SOCIETY; ECHOCARDIOGRAPHY; RECOMMENDATIONS; PREDICTORS; CARDIOLOGY; AREA Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31625