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Eligibility to COAPT trial in the daily practice: A real-world experience.
Zancanaro, Edoardo; Buzzatti, Nicola; Denti, Paolo; Guicciardi, Nicolò Azzola; Melillo, Enrico; Monaco, Fabrizio; Agricola, Eustachio; Ancona, Francesco; Alfieri, Ottavio; De Bonis, Michele; Maisano, Francesco.
Afiliação
  • Zancanaro E; Department of Cardiac Surgery, San Raffaele Scientific Institute, Milan, Italy.
  • Buzzatti N; Department of Cardiac Surgery, San Raffaele Scientific Institute, Milan, Italy.
  • Denti P; Department of Cardiac Surgery, San Raffaele Scientific Institute, Milan, Italy.
  • Guicciardi NA; Department of Cardiac Surgery, San Raffaele Scientific Institute, Milan, Italy.
  • Melillo E; Department of Cardiology and Heart Failure, Monaldi Hospital, Naples, Italy.
  • Monaco F; Department of Cardiac Anesthesia, San Raffaele Scientific Institute, Milan, Italy.
  • Agricola E; Cardiovascular Imaging Unit, San Raffaele Scientific Institute, Milan, Italy.
  • Ancona F; Cardiovascular Imaging Unit, San Raffaele Scientific Institute, Milan, Italy.
  • Alfieri O; Department of Cardiac Surgery, San Raffaele Scientific Institute, Milan, Italy.
  • De Bonis M; Department of Cardiac Surgery, San Raffaele Scientific Institute, Milan, Italy.
  • Maisano F; Department of Cardiac Surgery, San Raffaele Scientific Institute, Milan, Italy.
Catheter Cardiovasc Interv ; 104(2): 368-377, 2024 Aug.
Article em En | MEDLINE | ID: mdl-38923261
ABSTRACT

BACKGROUND:

The COAPT Trial was the first ever to demonstrate a survival benefit in treating functional mitral regurgitation (FMR). That was achieved through transcatheter mitral repair in selected patients. The exact proportion of patients fulfilling COAPT selection criteria in the real-world is unknown.

AIMS:

To assess the applicability of COAPT criteria in real world and its impact on patients' survival.

METHODS:

We assessed the clinical data and follow-up results of all consecutive patients admitted for FMR at our Department between January 2016 and May 2021 according to COAPT eligibility. COAPT eligibility was retrospectively assessed by a cardiac surgeon and a cardiologist.

RESULTS:

Among 394 patients, 56 (14%) were COAPT eligible. The most frequent reasons for exclusion were MR ≤ 2 (22%), LVEF < 20% or >50% (19%), and non-optimized GDMT (21.3%). Among Non-COAPT patients, weighted 4-year survival was higher in patients who received MitraClip compared to those who were left in optimized medical therapy (91.5% confidence interval [CI 0.864, 0.96] vs. 71.8% [CI 0.509, 0.926], respectively, p = 0.027).

CONCLUSIONS:

Only a minority (14%) of real-world patients with FMR referred to a tertiary hospital fulfilled the COAPT selection criteria. Among Non-COAPT patients, weighted 4-year survival was higher in patients who received MitraClip compared to those who were left in optimized medical therapy (91.5% [0.864, 0.96] vs. 71.8% [0.509, 0.926], respectively, p = 0.027).
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cateterismo Cardíaco / Seleção de Pacientes / Implante de Prótese de Valva Cardíaca / Definição da Elegibilidade / Valva Mitral / Insuficiência da Valva Mitral Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cateterismo Cardíaco / Seleção de Pacientes / Implante de Prótese de Valva Cardíaca / Definição da Elegibilidade / Valva Mitral / Insuficiência da Valva Mitral Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article