SYNTAX score II in patients with coronary artery disease undergoing percutaneous mitral repair with the MitraClip

Obeid, Slayman; Attinger‐Toller, Adrian; Taramasso, Maurizio; Pedrazzini, Giovanni; Suetsch, Gabor; Landolt, Fabienne; Karbeyaz, Fatih; Rodríguez, Hector P.; Sürder, Daniel; Moccetti, Tiziano; Nietlispach, Fabiàn

doi:10.1016/j.ijcard.2017.02.049

Cited by 10 publications

(10 citation statements)

References 29 publications

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“…In our study, those requiring PCI during the same index hospitalization most likely had more significant coronary artery disease and comorbidities and more likely to have nonelective admissions leading to the increased adverse outcomes. It has been reported that patients with higher SYNTAX II (Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) score were at higher risk of adverse events during and after Mitraclip implantation which further supports the hypothesis that not all CAD continuum has similar effects on the postprocedural outcomes 11 …”

Section: Discussionsupporting

confidence: 52%

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Impact of preexisting coronary arterial disease in patients undergoing percutaneous mitral valve repair (MitraClip)

Gifft

Omran

Ghrair

et al. 2020

Cathet Cardio Intervent

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Introduction Percutaneous mitral valve repair with Mitraclip device has been approved for the treatment of symptomatic mitral valve regurgitation in patients deemed high surgical risk. It's unclear whether the presence of preexisting coronary arterial disease (CAD) affects the postprocedural outcomes of Mitraclip. Methods The study population was extracted from the 2016 Nationwide Readmissions Data (NRD) using the International Classification of Diseases, Tenth Revision, Clinical Modifications/Procedure Coding System (ICD‐10‐CM/PCS) for Mitraclip, preexisting CAD, and postprocedural complications. Study primary endpoints included in‐hospital all‐cause mortality, cardiogenic shock, acute myocardial infarction (AMI), acute kidney injury (AKI), stroke, acute respiratory failure, length of hospital stay (LOS), and 30‐day readmission rate. Results A total of 2,539 discharges that had Mitraclip during the index hospitalization, 62.3% had history of preexisting CAD. Mean age was 78.5 years and 46.6% were female. Overall, the presence of preexisting CAD was associated with higher AMI (1.6 vs. 0.4%, p < .01), however, there was no significant differences in terms of in‐hospital all‐cause mortality (2.2 vs. 2.6%, p = .52), cardiogenic shock (3.4 vs. 4.1%, p = .39), AKI (14.7 vs. 13.6%, p = .43), stroke (0.9 vs. 0.5%, p = .31), acute respiratory failure (9.7 vs. 8.8%, p = .43), LOS (5.3 vs. 5.3 days, p = .85) or 30‐day readmission rate (14.6 vs. 14.4%, p = .92). These results persisted after adjustment for baseline characteristics. The subgroup of CAD patients who received percutaneous coronary intervention (PCI) was associated with higher in‐hospital mortality (22.5 vs. 2.0%, p < .01), cardiogenic shock (25.0 vs. 3.3%, p < .01), AMI (22.5 vs. 0.8%, p < .01), AKI (55.0 vs. 13.7%, p < .01), stroke (10.0 vs. 0.6%, p < .01), acute respiratory failure (45.0 vs. 8.8%, p < .01), and longer LOS (21.5 vs. 5.1 days, p < .01), however there was no significant difference in 30‐day readmission rate (15.0 vs. 14.5%, p = .95). Conclusions Preexisting CAD was associated with higher in‐hospital AMI post‐Mitraclip but with comparable mortality and other morbidities. Patients who received PCI during the same index hospitalization had higher in‐hospital mortality and morbidity.

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Section: Discussionsupporting

confidence: 52%

“…A previous study showed a history of myocardial infarction was a predictor of worse outcomes in patients undergoing percutaneous Mitraclip implantation 11 . One explanation for the current study findings is that CAD is a continuum of varying degrees of severity.…”

Section: Discussionsupporting

confidence: 47%

Impact of preexisting coronary arterial disease in patients undergoing percutaneous mitral valve repair (MitraClip)

Gifft

Omran

Ghrair

et al. 2020

Cathet Cardio Intervent

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“…Interestingly, the presence of preexisting CAD was associated with higher acute myocardial infarction (AMI) (1.6% vs. 0.4%, p < .01); however, there was no significant differences in terms of in‐hospital all‐cause mortality, cardiogenic shock, acute kidney injury (AKI), stroke, acute respiratory failure, length of stay (LOS), 30 day readmission. In a recent investigation, in a cohort of 75 patients underwent MitraClip procedure and concomitant CAD, Obeid et al 5 demonstrated that high SYNTAX II (synergy between percutaneous coronary intervention [PCI] with taxus and cardiac surgery) score (≥ 54.5) was independently associated with adverse events, comprising all‐cause mortality, mitral valve surgery due to failure of PMVR or reoperation, hospitalization for congestive heart failure, heart transplantation, and the composite of all four endpoints (OR = 6.12, 95% confidence interval [CI] 1.45–25.86, p = .014). Moreover, patients with a history of myocardial infarction were at a higher risk of adverse events during and after MitraClip implantation (OR = 3.57, 95% CI 1.17–10.88, p = .025).…”

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confidence: 99%

Coronary arterial disease in patients undergoing percutaneous edge‐to‐edge mitral valve repair: Handle with care

Musumeci

Colopi

2021

Cathet Cardio Intervent

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Key Points Percutaneous mitral valve repair using the MitraClip System is a revolutionary treatment option for patients with severe mitral regurgitation (MR) and prohibitive surgical risk. Coronary arterial disease is a frequent comorbidity in patients with severe MR. The impact of concomitant coronary artery disease and revascularization on outcome in patients undergoing transcatheter mitral valve repair is still an ongoing debate.

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“…SS-II may be a more useful tool than SS for predicting no-reflow phenomenon after primary PCI [4]. Additionally, prognostic significance of SS-II is widening, and it is applicable for clinical utility in valvular heart disease [5].…”

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confidence: 99%

Residual SYNTAX score II and complex percutaneous coronary interventions

Cerit

2018

Journal of the Saudi Heart Association

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SYNTAX score II in patients with coronary artery disease undergoing percutaneous mitral repair with the MitraClip

Cited by 10 publications

References 29 publications

Impact of preexisting coronary arterial disease in patients undergoing percutaneous mitral valve repair (MitraClip)

Impact of preexisting coronary arterial disease in patients undergoing percutaneous mitral valve repair (MitraClip)

Coronary arterial disease in patients undergoing percutaneous edge‐to‐edge mitral valve repair: Handle with care

Residual SYNTAX score II and complex percutaneous coronary interventions

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