Long-term outcome, survival and predictors of mortality after MitraClip therapy: Results from the German Transcatheter Mitral Valve Interventions (TRAMI) registry

Background MitraClip therapy is increasingly used in patients deemed inoperable to treat severe mitral regurgitation (MR), but long-tern data is scarce. Aims The multicentre, industry-independent German Transcatheter Mitral Valve Interventions (TRAMI) registry comprises the largest prospectively enr...

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Hauptverfasser: Kalbacher, Daniel (VerfasserIn) , Bekeredjian, Raffi (VerfasserIn) , Zahn, Ralf (VerfasserIn) , Senges, Jochen (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2019
In: International journal of cardiology
Year: 2018, Jahrgang: 277, Pages: 35-41
ISSN:1874-1754
DOI:10.1016/j.ijcard.2018.08.023
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1016/j.ijcard.2018.08.023
Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0167527318323106
Volltext
Verfasserangaben:Daniel Kalbacher, Ulrich Schäfer, R. Stephan v. Bardeleben, Holger Eggebrecht, Horst Sievert, Georg Nickenig, Christian Butter, Andreas E. May, Raffi Bekeredjian, Taoufik Ouarrak, Karl-Heinz Kuck, Björn Plicht, Ralf Zahn, Stephan Baldus, Hüseyin Ince, Wolfgang Schillinger, Peter Boekstegers, Jochen Senges, Edith Lubos

MARC

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245 1 0 |a Long-term outcome, survival and predictors of mortality after MitraClip therapy  |b Results from the German Transcatheter Mitral Valve Interventions (TRAMI) registry  |c Daniel Kalbacher, Ulrich Schäfer, R. Stephan v. Bardeleben, Holger Eggebrecht, Horst Sievert, Georg Nickenig, Christian Butter, Andreas E. May, Raffi Bekeredjian, Taoufik Ouarrak, Karl-Heinz Kuck, Björn Plicht, Ralf Zahn, Stephan Baldus, Hüseyin Ince, Wolfgang Schillinger, Peter Boekstegers, Jochen Senges, Edith Lubos 
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520 |a Background MitraClip therapy is increasingly used in patients deemed inoperable to treat severe mitral regurgitation (MR), but long-tern data is scarce. Aims The multicentre, industry-independent German Transcatheter Mitral Valve Interventions (TRAMI) registry comprises the largest prospectively enrolled cohort of patients treated by MitraClip therapy. The current analysis is focusing on long-term mortality rates, cardiac rehospitalization and reintervention. Methods and results Long-term follow-up (median time 1037days) in the TRAMI registry was available for 722 patients treated at 20 German centres. Improvements in New York Heart Association (NYHA) functional class (I/II long-term: 65% vs. 1-year follow-up: 63.3%) and self-rated health-status (EuroQuol visual analogue scale [EQ VAS] long-term: 60 [50-70] vs. 1-year follow-up: 60 [50; 70]) were pertained over time. Estimated mortality rates by Kaplan-Meier method were 19.7% for 1-year, 31.9% for 2-year and 53.1% for 4-year follow-up without differences found for MR aetiology. Multivariable Cox-regression analysis identified previous aortic valve implantation (hazard ratio [HR]=2.21; p<0.0001), NYHA class IV (HR=1.78; p<0.001), prior cardiac decompensation (HR=1.63; p<0.001), creatinine>1.5mg/dl (HR=1.63; p<0.0001) and left ventricular ejection fraction<30% (HR=1.60; p<0.001) as most predictive for long-term mortality. Conclusions Long-term outcome in the TRAMI registry confirmed lasting clinical improvements and low intervention rates. Long-term mortality was strongly influenced by cardiac and non-cardiac co-morbidities and was found comparable for both MR aetiologies. 
534 |c 2018 
650 4 |a Heart failure 
650 4 |a MitraClip 
650 4 |a Mitral regurgitation 
650 4 |a TRAMI registry 
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