Does MTEER plus GDMT reduce mortality and HF hospitalization in patients with functional mitral regurgitation and heart failure compared to GDMT alone?
In patients with functional mitral regurgitation and heart failure, MTEER added to GDMT reduces cardiovascular mortality and heart failure hospitalizations while improving functional status.
Background: Mitral transcatheter edge-to-edge repair (MTEER) and guideline-directed medical therapy (GDMT) may be used to treat functional mitral regurgitation (FMR) with heart failure (HF). The optimal management of FMR is unclear. Methods: We performed a contemporary systematic review and meta-analysis comparing MTEER vs GDMT. PubMed, Embase, and Cochrane Central were systematically searched for randomized controlled trials and propensity score matched studies comparing outcomes of MTEER plus GDMT vs GDMT alone in FMR with HF. Odds ratios and risk ratios (RRs) with 95% CI were estimated using random-effects models. Results: < .01). There was no statistically significant difference in the risk of myocardial infarction or stroke between the groups. Conclusion: MTEER reduced all-cause cardiovascular mortality and HF hospitalization in patients with FMR and HF compared with GDMT alone. Additionally, MTEER resulted in a significant improvement in functional status in these patients.
Bendaham et al. (Tue,) studied this question.