Predictors of rehospitalization after percutaneous edge‐to‐edge mitral valve repair by MitraClip implantation

Abstract

After MitraClip implantation, annual rate of rehospitalization for decompensated heart failure was reduced by 65.8%. Baseline left ventricular ejection fraction, baseline troponin T and pre-procedural NYHA functional class are independent predictors for rehospitalization within the first year after MitraClip implantation. Patients readmitted for decompensated heart failure after MitraClip implantation had a 2.3-fold increased risk of all-cause mortality and a 3.3-fold increased risk of cardiovascular mortality compared to patients not requiring rehospitalization.

February 2019 at a glance: pathophysiology, exercise capacity, diuretics and valve disease

“…Baseline LV ejection fraction, troponin T and New York Heart Association class were independent predictors of 1‐year rehospitalization after MitraClip implantation. Rehospitalization was associated with a 2.3 and 3.3 increased risk of subsequent cardiovascular and all‐cause mortality, respectively …”

‘Finding the biomarker’ for transcatheter mitral valve repair

“…In the study of Keßler et al ., higher levels of TnT but not NT‐proBNP were observed in the rehospitalization group; this could be explained by the observation made by Jungbauer et al . that small increments of hs‐TnT are more sensitive to predict a clinical compromise secondary to HF.…”

“…In the study of Keßler et al ., the strongest predictive factors for rehospitalization and mortality were impaired LVEF and troponin T, reflecting the most compromised clinical status of the patients undergoing MitraClip procedure.…”

“…In this issue of the Journal, Keßler et al . report a rate of rehospitalization for HF decompensation of 18% in the first year after MitraClip procedure and that rehospitalization correlates significantly with all‐cause mortality (odds ratio 2.3, 95% confidence interval 1.3–4.1; P = 0.004) and cardiovascular mortality (odds ratio 3.3, 95% confidence interval 1.7–6.1; P = 0.0003).…”

“…Data from the TRAMI registry established a 1‐year mortality of 20.3% with a rehospitalization rate during the first year of 64.3%, of which 14.1% secondary to cardiac decompensation and 17.8% to other cardiovascular reasons . Predictors of 1‐year mortality were NYHA class IV, anaemia, previous aortic valve intervention, serum creatinine ≥ 1.5 mg/dL, peripheral artery disease, LVEF < 30%, severe tricuspid regurgitation, and procedural failure …”