Baseline Characteristics Might Predict Response to Therapy in Patients with Secondary Mitral Regurgitation

Super-responders in the COAPT trial had lower baseline creatinine and quality-of-life scores and were more likely to be treated with transcatheter repair.

The manufacturer-funded, randomized COAPT trial (NCT01626079; NEJM JW Cardiol Nov 2018 and N Engl J Med 2018; 379:2307) demonstrated the benefit of transcatheter mitral-valve (MV) repair with MitraClip for patients with secondary mitral regurgitation (MR), but not all patients responded to the same degree. In a post hoc analysis of 573 COAPT participants, investigators sought to identify predictors of super-response, defined as being alive without heart failure (HF) hospitalization and ≥20-point improvement at 1 year in the Kansas City Cardiomyopathy Questionnaire (KCCQ) overall score.

The researchers found super-response in 27% of participants receiving the device plus guideline-directed medical treatment (GDMT) and 10% of control patients …

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)