| 000 | 05111nam a22006497a 4500 | ||
|---|---|---|---|
| 008 | 201006s20202020 xxu||||| |||| 00| 0 eng d | ||
| 022 | _a0735-1097 | ||
| 024 | _a10.1016/j.jacc.2020.07.035 [doi] | ||
| 024 | _aS0735-1097(20)36034-4 [pii] | ||
| 040 | _aOvid MEDLINE(R) | ||
| 099 | _a32912445 | ||
| 245 | _aImpact of Tricuspid Regurgitation on Clinical Outcomes: The COAPT Trial. | ||
| 251 | _aJournal of the American College of Cardiology. 76(11):1305-1314, 2020 09 15. | ||
| 252 | _aJ Am Coll Cardiol. 76(11):1305-1314, 2020 09 15. | ||
| 252 | _zJ Am Coll Cardiol. 76(11):1305-1314, 2020 Sep 15. | ||
| 253 | _aJournal of the American College of Cardiology | ||
| 260 | _c2020 | ||
| 260 | _fFY2021 | ||
| 265 | _sppublish | ||
| 265 | _sppublish | ||
| 266 | _d2020-10-06 | ||
| 268 | _aJournal of the American College of Cardiology. 76(11):1305-1314, 2020 Sep 15. | ||
| 501 | _aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007 | ||
| 520 | _aBACKGROUND: The presence of tricuspid regurgitation (TR) may affect prognosis in patients with mitral regurgitation (MR). | ||
| 520 | _aCONCLUSIONS: Patients with severe secondary MR who also had >=Mod TR had worse clinical and echocardiographic characteristics and worse clinical outcomes compared to those with <=Mild TR. Within the COAPT trial, MitraClip improved outcomes in patients with and without >=Mod TR severity compared with GDMT alone. (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation [COAPT]; NCT01626079). Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. | ||
| 520 | _aMETHODS: A total of 614 patients with symptomatic heart failure with moderate to severe (3+) or severe (4+) secondary MR were randomized to maximally tolerated GDMT plus MitraClip or GDMT alone; 599 had core laboratory evaluable echocardiograms. Patients were divided into 2 groups by baseline TR severity: none/trace/mild TR (<=Mild TR) (n = 501 [83.6%]) and moderate/severe TR (>=Mod TR) (n = 98 [16.4%]). Two-year composite endpoints of death or heart failure hospitalization (HFH) and the individual endpoints were analyzed. | ||
| 520 | _aOBJECTIVES: This study sought to determine the impact of TR on outcomes in patients with heart failure and severe secondary MR randomized to guideline-directed medical therapy (GDMT) or edge-to-edge repair with the MitraClip in the COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation) trial. | ||
| 520 | _aRESULTS: Patients with >=Mod TR were more likely to be New York Heart Association functional class III/IV (p < 0.0001) and have a Society of Thoracic Surgeons score of >=8 (p < 0.0001), anemia (p = 0.02), chronic kidney disease (p = 0.003), and higher N-terminal pro-B-type natriuretic peptide (p = 0.02) than those with <=Mild TR. Patients with >=Mod TR had more severe MR (p = 0.0005) despite smaller left ventricular volumes (p = 0.005) and higher right ventricular systolic pressure (p < 0.0001). At 2 years, the composite rate of death or HFH was higher in patients with >=Mod TR compared with <=Mild TR treated with GDMT alone (83.0% vs. 64.3%; hazard ratio: 1.74; 95% confidence interval: 1.24 to 2.45; p = 0.001) but not following MitraClip (48.2% vs. 44.0%; hazard ratio: 1.14; 95% confidence interval: 0.71 to 1.84; p = 0.59). Rates of death or HFH, as well as death and HFH alone, were reduced by MitraClip compared with GDMT, irrespective of baseline TR grade (pinteraction = 0.16, 0.29, and 0.21 respectively). | ||
| 546 | _aEnglish | ||
| 650 | _a*Heart Failure/dg [Diagnostic Imaging] | ||
| 650 | _a*Heart Failure/su [Surgery] | ||
| 650 | _a*Mitral Valve Insufficiency/dg [Diagnostic Imaging] | ||
| 650 | _a*Mitral Valve Insufficiency/su [Surgery] | ||
| 650 | _a*Tricuspid Valve Insufficiency/dg [Diagnostic Imaging] | ||
| 650 | _a*Tricuspid Valve Insufficiency/su [Surgery] | ||
| 650 | _aAged | ||
| 650 | _aAged, 80 and over | ||
| 650 | _aEchocardiography/td [Trends] | ||
| 650 | _aFemale | ||
| 650 | _aFollow-Up Studies | ||
| 650 | _aHeart Failure/ep [Epidemiology] | ||
| 650 | _aHumans | ||
| 650 | _aMale | ||
| 650 | _aMiddle Aged | ||
| 650 | _aMitral Valve Insufficiency/ep [Epidemiology] | ||
| 650 | _aSurgical Instruments/td [Trends] | ||
| 650 | _aTreatment Outcome | ||
| 650 | _aTricuspid Valve Insufficiency/ep [Epidemiology] | ||
| 651 | _aMedStar Heart & Vascular Institute | ||
| 657 | _aJournal Article | ||
| 700 | _aAsch, Federico M | ||
| 700 | _aMedvedofsky, Diego | ||
| 700 | _aWeissman, Neil J | ||
| 790 | _aAbraham WT, Asch F, Ben-Yehuda O, Chen S, Grayburn P, Hahn RT, Kapadia S, Kar S, Lim S, Lindenfeld J, Liu M, Mack MJ, Medvedofsky D, Puri R, Redfors B, Sannino A, Shahim B, Stone GW, Weissman NJ | ||
| 856 |
_uhttps://dx.doi.org/10.1016/j.jacc.2020.07.035 _zhttps://dx.doi.org/10.1016/j.jacc.2020.07.035 |
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| 942 |
_cART _dArticle |
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| 999 |
_c5636 _d5636 |
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