Differential effects of anaemia and iron deficiency on long-term outcomes following transcatheter edge-to-edge repair in degenerative vs. secondary mitral regurgitation: results from a large single-center study
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Differential effects of anaemia and iron deficiency on long-term outcomes following transcatheter edge-to-edge repair in degenerative vs. secondary mitral regurgitation: results from a large single-center study. / Khurrami, Schajesta; Köll, Benedikt; Ludwig, Sebastian; Pauschinger, Christoph; Weimann, Jessica; Reichenspurner, Hermann; Conradi, Lenard; Schaefer, Andreas; Blankenberg, Stefan; Lubos, Edith; Schofer, Niklas; Kalbacher, Daniel.
In: CLIN RES CARDIOL, Vol. 112, No. 7, 07.2023, p. 967-980.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Differential effects of anaemia and iron deficiency on long-term outcomes following transcatheter edge-to-edge repair in degenerative vs. secondary mitral regurgitation: results from a large single-center study
AU - Khurrami, Schajesta
AU - Köll, Benedikt
AU - Ludwig, Sebastian
AU - Pauschinger, Christoph
AU - Weimann, Jessica
AU - Reichenspurner, Hermann
AU - Conradi, Lenard
AU - Schaefer, Andreas
AU - Blankenberg, Stefan
AU - Lubos, Edith
AU - Schofer, Niklas
AU - Kalbacher, Daniel
N1 - © 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
PY - 2023/7
Y1 - 2023/7
N2 - BACKGROUND: Anaemia and iron deficiency (ID) are independently associated with adverse outcomes in patients with cardiovascular diseases, especially in those with heart failure. Here, we aimed to clarify the long-term effect of anaemia and ID on outcomes in patients undergoing transcatheter mitral edge-to-edge repair (TEER) for relevant mitral regurgitation (MR) as well as to relate these to the underlying MR aetiology.METHODS: 833 patients (median age 77.1 years, 40.7% women, 63.3% secondary MR) treated by TEER between 09/2008 and 07/2019 were included and stratified according to baseline anaemia (hemoglobin < 12 g/dL in women and < 13 g/dL in men) or ID.RESULTS: Anaemia and ID were frequent with 61.6% and 68.1%, respectively. Anaemic patients had a lower functional status at baseline and were less likely to improve after TEER. In addition, anaemia was associated with all-cause mortality (hazard ratio [HR] = 1.68, 95% confidence interval [CI] 1.36-2.07, p < 0.001) and the composite endpoint of death or heart failure (HF) rehospitalization (HR = 1.30, 95% CI 1.10-1.54, p = 0.002). In contrast, ID was not associated with either all-cause mortality or the composite endpoint of death or HF rehospitalization.CONCLUSION: Patients undergoing TEER have high rates of both anaemia and ID. However, anaemia is associated with worse functional baseline status and post-interventional improvements compared to ID. Furthermore, anaemia is linked to higher rates of mortality and HF rehospitalization, particularly in those with secondary MR.
AB - BACKGROUND: Anaemia and iron deficiency (ID) are independently associated with adverse outcomes in patients with cardiovascular diseases, especially in those with heart failure. Here, we aimed to clarify the long-term effect of anaemia and ID on outcomes in patients undergoing transcatheter mitral edge-to-edge repair (TEER) for relevant mitral regurgitation (MR) as well as to relate these to the underlying MR aetiology.METHODS: 833 patients (median age 77.1 years, 40.7% women, 63.3% secondary MR) treated by TEER between 09/2008 and 07/2019 were included and stratified according to baseline anaemia (hemoglobin < 12 g/dL in women and < 13 g/dL in men) or ID.RESULTS: Anaemia and ID were frequent with 61.6% and 68.1%, respectively. Anaemic patients had a lower functional status at baseline and were less likely to improve after TEER. In addition, anaemia was associated with all-cause mortality (hazard ratio [HR] = 1.68, 95% confidence interval [CI] 1.36-2.07, p < 0.001) and the composite endpoint of death or heart failure (HF) rehospitalization (HR = 1.30, 95% CI 1.10-1.54, p = 0.002). In contrast, ID was not associated with either all-cause mortality or the composite endpoint of death or HF rehospitalization.CONCLUSION: Patients undergoing TEER have high rates of both anaemia and ID. However, anaemia is associated with worse functional baseline status and post-interventional improvements compared to ID. Furthermore, anaemia is linked to higher rates of mortality and HF rehospitalization, particularly in those with secondary MR.
KW - Male
KW - Humans
KW - Female
KW - Aged
KW - Mitral Valve Insufficiency/surgery
KW - Anemia/complications
KW - Iron Deficiencies
KW - Heart Failure/complications
KW - Patient Readmission
KW - Treatment Outcome
KW - Heart Valve Prosthesis Implantation
U2 - 10.1007/s00392-023-02210-7
DO - 10.1007/s00392-023-02210-7
M3 - SCORING: Journal article
C2 - 37129668
VL - 112
SP - 967
EP - 980
JO - CLIN RES CARDIOL
JF - CLIN RES CARDIOL
SN - 1861-0684
IS - 7
ER -
