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  3. Guideline-directed medical therapy in patients undergoing transcatheter edge-to-edge repair for secondary mitral regurgitation

Guideline-directed medical therapy in patients undergoing transcatheter edge-to-edge repair for secondary mitral regurgitation

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • Francisco Pedro Morais Dias De Almeida Sampaio

    Autor

  • Diogo Alexandre Santos Ferreira

    Autor

Participantes de fora da FMUP

  • Higuchi, Satoshi
  • Orban, Mathias
  • Adamo, Marianna
  • Giannini, Cristina
  • Melica, Bruno
  • Karam, Nicole
  • Praz, Fabien
  • Kalbacher, Daniel
  • Koell, Benedikt
  • Stolz, Lukas
  • Braun, Daniel
  • Naebauer, Michael
  • Wild, Mirjam
  • Doldi, Philipp
  • Neuss, Michael
  • Butter, Christian
  • Kassar, Mohammad
  • Ruf, Tobias
  • Petrescu, Aniela
  • Ludwig, Sebastian
  • Pfister, Roman
  • Iliadis, Christos
  • Unterhuber, Matthias
  • Thiele, Holger
  • Baldus, Stephan
  • von Bardeleben, Ralph Stephan
  • Massberg, Steffen
  • Windecker, Stephan
  • Lurz, Philipp
  • Petronio, Anna Sonia
  • Lindenfeld, JoAnn
  • Abraham, William T.
  • Metra, Marco
  • Hausleiter, Joeg
  • EuroSMR Investigators

Unidades de investigação

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] .

Dados da publicação

ISSN/ISSNe:
1388-9842, 1879-0844

European Journal of Heart Failure  Wiley-Blackwell

Tipo:
Article
Páginas:
2152-2161
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 19

Citações Recebidas na Scopus: 19

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Keywords

  • Guideline-directed medical therapy; Secondary mitral regurgitation; Heart failure with reduced ejection fraction; Transcatheter edge-to-edge-repair; Comorbidities; Residual mitral regurgitation

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Proyectos asociados

Impacto dos acessos femorais guiados por ecografia vs fluoroscopia nas complicações vasculares associadas à implantação de válvula aórtica percutânea

Investigador Principal: Francisco Pedro Morais Dias de Almeida Sampaio

Estudo Clínico Académico . 2021

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