Temporal trend and potential impact of angiotensin receptor neprilysin inhibitors on transcatheter edge-to-edge mitral valve repair.
Rev Esp Cardiol (Engl Ed)
; 75(12): 1001-1010, 2022 Dec.
Article
em En, Es
| MEDLINE
| ID: mdl-35272968
ABSTRACT
INTRODUCTION AND OBJECTIVES:
Transcatheter edge-to-edge repair (TEER) should be considered in patients with heart failure and secondary mitral regurgitation (MR). Angiotensin receptor-neprilysin inhibitors (ARNIs) have been demonstrated to improve prognosis in heart failure. We aimed to evaluate the impact ARNIs on patient selection and outcomes.METHODS:
The population of the Spanish TEER prospective registry (March 2012 to January 2021) was divided into 2 groups a) TEER before the ARNI era (n=450) and b) TEER after the recommendation of ARNIs by European Guidelines (n=639), with further analysis according to intake (n=52) or not (n=587) of ARNIs.RESULTS:
A total of 1089 consecutive patients underwent TEER for secondary MR. In the ARNI era, there was a reduction in left ventricle dilation (82mL vs 100mL, P=.025), and better function (35% vs 38%, P=.011). At 2 years of follow-up, mortality (10.6% vs 17.3%, P <.001) and heart failure readmissions (16.6% vs 27.8%, P <.001) were lower in the ARNI era, but not recurrent MR. In the ARNI era, 1- and 2-year mortality were similar irrespective of ARNI intake but patients on ARNIs had a lower risk of readmission+mortality at 2 years (OR, 0.369; 95%CI, 0.137-0.992; P=.048), better NYHA class, and lower recurrence of MR III-IV (1.9% vs 14.3%, P=.011).CONCLUSIONS:
Better patient selection for TEER has been achieved in the last few years with a parallel improvement in outcomes. The use of ARNIs was associated with a significant reduction in overall events, better NYHA class, and lower MR recurrence.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Neprilisina
/
Insuficiência Cardíaca
/
Insuficiência da Valva Mitral
Limite:
Humans
Idioma:
En
/
Es
Revista:
Rev Esp Cardiol (Engl Ed)
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Espanha