Key result
A history of cancer did not impact 1-year survival after transcatheter mitral valve repair compared to non-cancer patients, although active cancer was associated with increased mortality.
Why the study?
History of cancer is common in patients undergoing TMVR, but its impact on post-procedure outcomes remained to be examined.
Does a history of cancer impact clinical and functional outcomes in patients with symptomatic mitral regurgitation undergoing transcatheter mitral valve repair?
Cohort (n=661)
No
Does a history of cancer impact clinical and functional outcomes in patients with symptomatic mitral regurgitation undergoing transcatheter mitral valve repair?
Answers are grounded in this paper and cite their sources.
Transcatheter mitral valve repair is equally effective and safe in patients with a history of cancer compared to those without, though active cancer is associated with higher long-term mortality.
BACKGROUND: History of cancer is common in patients undergoing transcatheter mitral valve repair (TMVR). OBJECTIVES: Aim was to examine the impact of cancer history on outcomes after TMVR. METHODS: In patients of a monocentric prospective registry of TMVR history of cancer was retrospectively assessed from records. Associations with 6-week functional outcomes and clinical outcomes during a median follow-up period of 594 days were examined. RESULTS: Of 661 patients (mean age 79 years; age-range 37-101 years; 56.1% men), 21.6% had a history of cancer with active disease in 4.1%. Compared with non-cancer patients, cancer patients had a similar procedural success rate (reduction of mitral regurgitation to grade 2 or lower 91.6% vs. 88%; p = 0.517) and similar relevant improvement in 6-min walking distance, NYHA class, Minnesota Living with Heart Failure Questionnaire score and Short Form 36 scores. 1-year survival (83% vs. 82%; p = 0.813) and 1-year survival free of heart failure decompensation (75% vs. 76%; p = 0.871) were comparable between cancer and non-cancer patients. Patients with an active cancer disease showed significantly higher mortality compared with patients having a history of cancer (hazard ratio 2.05 [95% CI 1.11-3.82; p = 0.023]) but similar mortality at landmark analysis of 1 year. CONCLUSION: TMVR can be performed with equal efficacy in patients with and without cancer and symptomatic mitral regurgitation. Cancer patients show comparable clinical outcome and short-term functional improvement as non-cancer patients. However, longterm mortality was increased in patients with active cancer underlining the importance of patient selection within the heart-team evaluation.
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Kalkan et al. (2023) conducted a cohort in Symptomatic severe mitral regurgitation (n=661). History of cancer vs. No history of cancer was evaluated on 1-year survival (p=0.813). A history of cancer did not impact 1-year survival after transcatheter mitral valve repair compared to non-cancer patients, although active cancer was associated with increased mortality.
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