Transcatheter edge-to-edge repair (TEER) is associated with significant improvements among young and elderly heart failure patients, according to a new study published in JACC: Cardiovascular Interventions.
“Key considerations when selecting patients who will benefit from MitraClip therapy include valvular anatomy, the degree and type of regurgitation, the severity of left ventricular dysfunction, symptoms, age and other comorbidities that may contribute to risk for suboptimal procedural and clinical outcomes,” wrote lead author Chris Song, with the Icahn School of Medicine at Mount Sinai in New York City, and colleagues. “Given the prevalence of SMR in elderly patients and the continued growth of the elderly population, age is likely to become an increasingly important factor to consider when evaluating patients for medical and device treatment.”
The analysis focused on data from 614 patients who had previously participated in the COAPT trial. All patients presented with moderate to severe or severe secondary mitral regurgitation (SMR). While 312 patients were treated with guideline-directed medical therapy (GDMT) alone, 302 patients underwent TEER with the MitraClip device.
While 48.4% of patients were under the age of 74, with a median group age of 66, the remaining patients were 75 and older, with a median group age of 80. Patients in the older patient group were more likely to present with hypertension, atrial fibrillation and chronic kidney disease. Diabetes, however, was more common in the younger patient group.
Overall, the authors found, TEER was associated with improved outcomes across the board. Mortality or hospitalization for heart failure within two years was seen in 37.3% of younger TEER patients and 64.5% of younger GDMT patients. That same endpoint was seen in 51.7% of older TEER patients and 69.6% of older GDMT patients.
The two patient groups also saw “similar improvements” in quality of life after TEER compared to GDMT alone.
“Young as well as elderly patients with heart failure and severe SMR substantially benefited from TEER with the MitraClip device,” the authors wrote. “Thus, age should not be an impediment for early referral of selected patients with heart failure and severe SMR for MitraClip treatment.”
Abbott, the manufacturer of the MitraClip device, funded the original COAPT trial. Some of this study’s co-authors also reported prior relationships with Abbott.
The full study is available here.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.