Key result
High MAGGIC score linked to ~4-fold higher 1-year mortality after M-TEER in functional MR.
Why the study?
The prognostic value of the MAGGIC score in patients undergoing mitral valve transcatheter edge-to-edge repair remains unclear.
Does the MAGGIC score predict all-cause death in patients undergoing mitral valve transcatheter edge-to-edge repair?
Observational (n=3,609)
Yes
Does the MAGGIC score predict all-cause death in patients undergoing mitral valve transcatheter edge-to-edge repair?
Hazard Ratio: 4.15 (95% CI 2.34–7.36)
Absolute Event Rate: 27.3% vs 6.6%
p-value: p=<0.001
The MAGGIC score independently predicts 1- and 3-year all-cause death after M-TEER in both functional and degenerative mitral regurgitation, demonstrating comparable or superior performance to conventional surgical and M-TEER-specific risk models.
High MAGGIC scores may identify FMR patients at higher 1-year death risk after M-TEER; extends HF risk models to this population but requires prospective validation.
Background The prognostic value of the Meta‐Analysis Global Group in Chronic Heart Failure (MAGGIC) score in patients undergoing mitral valve transcatheter edge‐to‐edge repair (M‐TEER) remains unclear. This study evaluated the MAGGIC score to predict outcomes after M‐TEER in patients with functional (FMR) or degenerative mitral regurgitation (DMR) and compared its performance with conventional surgical and M‐TEER–specific risk models. Methods We analyzed 3609 patients (FMR, 71%; DMR, 29%) who underwent M‐TEER in the OCEAN (Optimized Catheter Valvular Intervention)‐Mitral registry. Patients were stratified into MAGGIC score tertiles. The primary outcome was all‐cause death at 1 and 3 years. Secondary outcomes included cardiovascular death. Predictive performance was compared with Society of Thoracic Surgeons score, European System for Cardiac Operative Risk Evaluation II, MitraScore, and COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation) score. Results The median age was 81 years, 55.3% were men, and median MAGGIC score was 30. In the FMR cohort, patients in tertile 3 had higher risks of all‐cause death (1 year: adjusted hazard ratio [HR adj ], 4.15 [95% CI, 2.34–7.36]; 3 years: HR adj , 1.83 [95% CI, 1.22–2.77]) and cardiovascular death (1 year: HR adj , 2.31 [95% CI, 1.56–3.43]; 3 years: HR adj , 1.61 [95% CI, 1.13–2.31]). In the DMR cohort, tertile 3 was associated with higher all‐cause death (1 year: HR adj , 2.84 [95% CI, 1.18–6.86]; 3 years: HR adj , 2.25 [95% CI, 1.07–4.73]) and cardiovascular death at 3 years (HR adj , 3.49 [95% CI, 1.23–9.84]). The MAGGIC score demonstrated comparable or superior discrimination on the basis of the concordance index. Conclusions The MAGGIC score independently predicted 1‐ and 3‐year all‐cause death after M‐TEER in both FMR and DMR cohorts and cardiovascular death in the FMR cohort and at 3 years in the DMR cohort. It demonstrated comparable or superior predictive performance to conventional surgical and M‐TEER–specific risk models.
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Nishimura et al. (2026) conducted an observational in Functional or degenerative mitral regurgitation undergoing M-TEER (n=3,609). High MAGGIC score (Tertile 3) vs. Low MAGGIC score (Tertile 1) was evaluated on All-cause death at 1 year (Functional Mitral Regurgitation cohort) (HR 4.15, 95% CI 2.34-7.36, p=<0.001). A high MAGGIC score (tertile 3) was independently associated with a significantly increased risk of 1-year all-cause death compared to a low score (tertile 1) in patients with functional mitral regurgitation undergoing M-TEER (HR 4.15).
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