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Percutaneous repair or medical treatment for secondary mitral regurgitation: outcomes at 2 years.

Abstract：

AIMS:The MITRA-FR trial showed that among symptomatic patients with severe secondary mitral regurgitation, percutaneous repair did not reduce the risk of death or hospitalization for heart failure at 12 months compared with guideline-directed medical treatment alone. We report the 24-month outcome from this trial. METHODS AND RESULTS:At 37 centres, we randomly assigned 304 symptomatic heart failure patients with severe secondary mitral regurgitation (effective regurgitant orifice area >20 mm2 or regurgitant volume >30 mL), and left ventricular ejection fraction between 15% and 40% to undergo percutaneous valve repair plus medical treatment (intervention group, n = 152) or medical treatment alone (control group, n = 152). The primary efficacy outcome was the composite of all-cause death and unplanned hospitalization for heart failure at 12 months. At 24 months, all-cause death and unplanned hospitalization for heart failure occurred in 63.8% of patients (97/152) in the intervention group and 67.1% (102/152) in the control group [hazard ratio (HR) 1.01, 95% confidence interval (CI) 0.77-1.34]. All-cause mortality occurred in 34.9% of patients (53/152) in the intervention group and 34.2% (52/152) in the control group (HR 1.02, 95% CI 0.70-1.50). Unplanned hospitalization for heart failure occurred in 55.9% of patients (85/152) in the intervention group and 61.8% (94/152) in the control group (HR 0.97, 95% CI 0.72-1.30). CONCLUSIONS:In patients with severe secondary mitral regurgitation, percutaneous repair added to medical treatment did not significantly reduce the risk of death or hospitalization for heart failure at 2 years compared with medical treatment alone.

journal_name

Eur J Heart Fail

journal_title

European journal of heart failure

authors

Iung B,Armoiry X,Vahanian A,Boutitie F,Mewton N,Trochu JN,Lefèvre T,Messika-Zeitoun D,Guerin P,Cormier B,Brochet E,Thibault H,Himbert D,Thivolet S,Leurent G,Bonnet G,Donal E,Piriou N,Piot C,Habib G,Rouleau F,Car

doi

10.1002/ejhf.1616

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

1619-1627

issue

eissn

1388-9842

issn

1879-0844

journal_volume

pub_type

杂志文章,多中心研究,随机对照试验

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Percutaneous repair or medical treatment for secondary mitral regurgitation: outcomes at 2 years.