Long-term outcome, survival and predictors of mortality after MitraClip therapy: Results from the German Transcatheter Mitral Valve Interventions (TRAMI) registry
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Long-term outcome, survival and predictors of mortality after MitraClip therapy: Results from the German Transcatheter Mitral Valve Interventions (TRAMI) registry. / Kalbacher, Daniel; Schäfer, Ulrich; V Bardeleben, R Stephan; Eggebrecht, Holger; Sievert, Horst; Nickenig, Georg; Butter, Christian; May, Andreas E; Bekeredjian, Raffi; Ouarrak, Taoufik; Kuck, Karl-Heinz; Plicht, Björn; Zahn, Ralf; Baldus, Stephan; Ince, Hüseyin; Schillinger, Wolfgang; Boekstegers, Peter; Senges, Jochen; Lubos, Edith.
in: INT J CARDIOL, Jahrgang 277, 15.02.2019, S. 35-41.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Long-term outcome, survival and predictors of mortality after MitraClip therapy: Results from the German Transcatheter Mitral Valve Interventions (TRAMI) registry
AU - Kalbacher, Daniel
AU - Schäfer, Ulrich
AU - V Bardeleben, R Stephan
AU - Eggebrecht, Holger
AU - Sievert, Horst
AU - Nickenig, Georg
AU - Butter, Christian
AU - May, Andreas E
AU - Bekeredjian, Raffi
AU - Ouarrak, Taoufik
AU - Kuck, Karl-Heinz
AU - Plicht, Björn
AU - Zahn, Ralf
AU - Baldus, Stephan
AU - Ince, Hüseyin
AU - Schillinger, Wolfgang
AU - Boekstegers, Peter
AU - Senges, Jochen
AU - Lubos, Edith
N1 - Copyright © 2018 Elsevier B.V. All rights reserved.
PY - 2019/2/15
Y1 - 2019/2/15
N2 - BACKGROUND: MitraClip therapy is increasingly used in patients deemed inoperable to treat severe mitral regurgitation (MR), but long-tern data is scarce.AIMS: The multicentre, industry-independent German Transcatheter Mitral Valve Interventions (TRAMI) registry comprises the largest prospectively enrolled cohort of patients treated by MitraClip therapy. The current analysis is focusing on long-term mortality rates, cardiac rehospitalization and reintervention.METHODS AND RESULTS: Long-term follow-up (median time 1037 days) in the TRAMI registry was available for 722 patients treated at 20 German centres. Improvements in New York Heart Association (NYHA) functional class (I/II long-term: 65% vs. 1-year follow-up: 63.3%) and self-rated health-status (EuroQuol visual analogue scale [EQ VAS] long-term: 60 [50-70] vs. 1-year follow-up: 60 [50; 70]) were pertained over time. Estimated mortality rates by Kaplan-Meier method were 19.7% for 1-year, 31.9% for 2-year and 53.1% for 4-year follow-up without differences found for MR aetiology. Multivariable Cox-regression analysis identified previous aortic valve implantation (hazard ratio [HR] = 2.21; p < 0.0001), NYHA class IV (HR = 1.78; p < 0.001), prior cardiac decompensation (HR = 1.63; p < 0.001), creatinine > 1.5 mg/dl (HR = 1.63; p < 0.0001) and left ventricular ejection fraction < 30% (HR = 1.60; p < 0.001) as most predictive for long-term mortality.CONCLUSIONS: Long-term outcome in the TRAMI registry confirmed lasting clinical improvements and low intervention rates. Long-term mortality was strongly influenced by cardiac and non-cardiac co-morbidities and was found comparable for both MR aetiologies.
AB - BACKGROUND: MitraClip therapy is increasingly used in patients deemed inoperable to treat severe mitral regurgitation (MR), but long-tern data is scarce.AIMS: The multicentre, industry-independent German Transcatheter Mitral Valve Interventions (TRAMI) registry comprises the largest prospectively enrolled cohort of patients treated by MitraClip therapy. The current analysis is focusing on long-term mortality rates, cardiac rehospitalization and reintervention.METHODS AND RESULTS: Long-term follow-up (median time 1037 days) in the TRAMI registry was available for 722 patients treated at 20 German centres. Improvements in New York Heart Association (NYHA) functional class (I/II long-term: 65% vs. 1-year follow-up: 63.3%) and self-rated health-status (EuroQuol visual analogue scale [EQ VAS] long-term: 60 [50-70] vs. 1-year follow-up: 60 [50; 70]) were pertained over time. Estimated mortality rates by Kaplan-Meier method were 19.7% for 1-year, 31.9% for 2-year and 53.1% for 4-year follow-up without differences found for MR aetiology. Multivariable Cox-regression analysis identified previous aortic valve implantation (hazard ratio [HR] = 2.21; p < 0.0001), NYHA class IV (HR = 1.78; p < 0.001), prior cardiac decompensation (HR = 1.63; p < 0.001), creatinine > 1.5 mg/dl (HR = 1.63; p < 0.0001) and left ventricular ejection fraction < 30% (HR = 1.60; p < 0.001) as most predictive for long-term mortality.CONCLUSIONS: Long-term outcome in the TRAMI registry confirmed lasting clinical improvements and low intervention rates. Long-term mortality was strongly influenced by cardiac and non-cardiac co-morbidities and was found comparable for both MR aetiologies.
KW - Aged
KW - Aged, 80 and over
KW - Cohort Studies
KW - Female
KW - Follow-Up Studies
KW - Germany/epidemiology
KW - Humans
KW - Male
KW - Mitral Valve Insufficiency/diagnostic imaging
KW - Mortality/trends
KW - Predictive Value of Tests
KW - Prospective Studies
KW - Registries
KW - Surgical Instruments/trends
KW - Time Factors
KW - Transcatheter Aortic Valve Replacement/mortality
KW - Treatment Outcome
U2 - 10.1016/j.ijcard.2018.08.023
DO - 10.1016/j.ijcard.2018.08.023
M3 - SCORING: Journal article
C2 - 30153994
VL - 277
SP - 35
EP - 41
JO - INT J CARDIOL
JF - INT J CARDIOL
SN - 0167-5273
ER -