Diabetes is associated with a greater risk of poor transcatheter mitral valve repair (TMVR) outcomes, according to a new analysis published in JACC: Heart Failure. However, those patients still appeared to see substantial benefits from undergoing the procedure.
The group’s analysis was an extension of the COAPT trial, which examined the safety and effectiveness of TMVR—now known as transcatheter edge-to-edge repair (TEER)—with the MitraClip device after 24 months.
Out of the study’s 614 patients, 229 (37.3%) presented with diabetes. Overall, the authors wrote, TMVR/TEER patients with diabetes had higher two-year rates of death (40.8% vs. 32.3%) and heart failure hospitalizations (50.1% vs. 43%) than patients without diabetes.
The procedure was still associated with significant improvements in quality of life for patients with and without diabetes when compared to guideline-directed medical therapy alone. The two-year rate of heart failure hospitalization was also lower for all patients who underwent TMVR/TEER—even those who presented with diabetes.
The authors did emphasize that this is far from the last word on this subject.
“Future studies should evaluate whether the MitraClip improves outcomes in patients with secondary mitral regurgitation (SMR) and concomitant diabetes who are more or less critically ill than those enrolled in COAPT, whether TMVR impacts longer term outcomes and whether emerging mitral valve technologies are as or more effective in high-risk heart failure patients with diabetes and SMR,” wrote first author Bahira Shahim, MD, PhD, a cardiologist at the Cardiovascular Research Foundation in New York City, and colleagues.
Abbott, the company behind the MitraClip device, funded this study. Numerous authors reported working relationships with Abbott.
Previous coverage related to the COAPT trial is available here, here and here.
Read the full JACC: Heart Failure analysis from Shahim et al. 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.