Increased risk of mortality and mortality has been linked to cardiogenic shock (CS) with mitral regurgitation (MR). Therefore, the researchers looked into the clinical characteristics and outcomes of CS patients who had transcatheter edge-to-edge repair (TEER) with the MitraClip to evaluate its effectiveness.
Data from over 600 patients who underwent the procedure between 2014 and 2018 were analyzed. The National Readmissions Database provided all of the data.
Of the total study population, 60% were male. The average patient age was 73 years. Nearly 28% of the patients had experienced an acute myocardial infarction (MI). The likelihood of requiring mechanical circulatory support (MCS) and a history of coronary artery disease (CAD) was high among patients with AMI. In addition, they had a lower risk of developing atrial fibrillation.
Notably, AMI patients had a higher rate of in-hospital mortality (29.6% vs. 20.4%). Compared to other studies where the rate of in-hospital mortality among AMI patients with severe MR was 55-60%, these figures represent a significant improvement. In addition, the researchers noted a similar 30-day readmission rate between AMI and non-AMI patient groups.
The lead author of the study, Medhat Farwati, MD, a specialist with Cleveland Clinic, and colleagues, said, “It is not entirely clear why patients in the non-AMI group had better survival than their counterparts with AMI. Although most baseline characteristics of the AMI and non-AMI groups were similar, MCS use was substantially lower in the latter group compared with those with AMI. This probably indicates a more favorable hemodynamic profile in the non-AMI group and thus may result in improved survival.”
The findings of this study suggest that despite being associated with high mortality and readmission rates, transcatheter edge-to-edge repair (TEER) with MitraClip in patients with CS and significant MR is a reasonable therapeutic option and may improve short-term outcomes.