Key result
Secondary MR TEER linked to ~19% 2-year cardiac mortality alongside 12% noncardiac deaths.
Why the study?
The relative impact of cardiac and noncardiac mortality in patients with secondary mitral regurgitation undergoing mitral transcatheter edge-to-edge repair had been poorly investigated.
What are the competing risks and independent predictors of cardiac and noncardiac mortality in patients with secondary mitral regurgitation treated with M-TEER?
Cohort (n=1,185)
Yes
What are the competing risks and independent predictors of cardiac and noncardiac mortality in patients with secondary mitral regurgitation treated with M-TEER?
In a real-world registry of patients with secondary mitral regurgitation undergoing M-TEER, there is a high 2-year cumulative incidence of both cardiac (19%) and noncardiac (12%) mortality, emphasizing the need for comprehensive risk assessment during patient selection.
Substantial competing cardiac and noncardiac mortality persists after M-TEER for secondary MR; supports refined risk models but leaves open prospective validation.
Background The relative impact of cardiac and noncardiac mortality in patients with secondary mitral regurgitation undergoing mitral transcatheter edge‐to‐edge repair (M‐TEER) has been poorly investigated. We aimed to assess the competing risks and independent predictors of cardiac and noncardiac mortality in a real‐world secondary mitral regurgitation population treated with M‐TEER and included in the GIOTTO (Italian Society of Interventional Cardiology [GIse] Registry Of Transcatheter Treatment of Mitral Valve Regurgitation) registry. Methods Competing risks analysis was used to assess the cumulative incidence of cardiac and noncardiac mortality. Cox regression identified independent predictors of each outcome. Co‐primary outcomes were cardiac and noncardiac death at 2 years. Results The analysis included 1185 consecutive patients with secondary mitral regurgitation treated with M‐TEER between January 2016 and March 2020 (median age 74 years). Two‐year cumulative incidences of cardiac and noncardiac mortality were 19% and 12%, respectively. At multivariable analysis, predictors of cardiac mortality were age (hazard ratio [HR], 1.03; P =0.002), New York Heart Association class (HR, 1.44; P =0.018), previous hospitalization for heart failure (HR, 1.67; P =0.016), hemoglobin (HR, 0.89; P =0.016), left ventricular end‐diastolic diameter (HR, 1.02; P =0.025), left ventricular ejection fraction (HR, 0.98; P =0.022), and daily furosemide dose (HR, 1.19; P =0.003). Predictors of noncardiac mortality were New York Heart Association class (HR, 1.70; P =0.03), estimated glomerular filtration rate (HR, 0.98; P =0.002), and smoking habit (HR, 1.82; P =0.009). Conclusions Patients with secondary mitral regurgitation treated with M‐TEER show a high 2‐year incidence of both cardiac and noncardiac mortality. Understanding competing risks of mortality may improve patient selection for M‐TEER.
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Esposito et al. (2025) conducted a cohort in Secondary mitral regurgitation (n=1,185). Mitral valve transcatheter edge-to-edge repair (M-TEER) was evaluated on Cardiac and noncardiac death at 2 years. Patients with secondary mitral regurgitation undergoing transcatheter edge-to-edge repair had 2-year cumulative incidences of cardiac and noncardiac mortality of 19% and 12%, respectively.
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