PMID- 26614824
OWN - NLM
STAT- MEDLINE
DCOM- 20170103
LR  - 20220408
IS  - 1522-9645 (Electronic)
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 37
IP  - 8
DP  - 2016 Feb 21
TI  - One-year outcomes and predictors of mortality after MitraClip therapy in 
      contemporary clinical practice: results from the German transcatheter mitral 
      valve interventions registry.
PG  - 703-12
LID - 10.1093/eurheartj/ehv627 [doi]
AB  - AIMS: The transcatheter mitral valve interventions (TRAMI) registry was 
      established in order to assess safety and efficacy of catheter-based mitral valve 
      interventional techniques in Germany, and prospectively enrolled 828 MitraClip 
      patients (median age 76 years, median log. EuroSCORE I 20.0%) between August 2010 
      and July 2013. We present the 1-year outcome in this MitraClip cohort-which is 
      the largest published to date. METHODS AND RESULTS: Seven forty-nine patients 
      (90.5%) were available for 1-year follow-up and included in the following 
      analyses. Mortality, major adverse cardiovascular event rates, and New York Heart 
      Association (NYHA) classes were recorded. Predictors of 1-year mortality were 
      identified by multivariate analysis using a Cox regression model with stepwise 
      forward selection. The 1-year mortality was 20.3%. At 1 year, 63.3% of TRAMI 
      patients pertained to NYHA functional classes I or II (compared with 11.0% at 
      baseline), and self-rated health status (on EuroQuol visual analogue scale) also 
      improved significantly by 10 points. Importantly, a significant proportion of 
      patients regained the complete independence in self-care after MitraClip 
      implantation (independence in 74.0 vs. 58.6% at baseline, P = 0.005). Predictors 
      of 1-year mortality were NYHA class IV (hazard ratio, HR 1.62, P = 0.02), anaemia 
      (HR 2.44, P = 0.02), previous aortic valve intervention (HR 2.12, P = 0.002), 
      serum creatinine >/=1.5 mg/dL (HR 1.77, P = 0.002), peripheral artery disease (HR 
      2.12, P = 0.0003), left ventricular ejection fraction <30% (HR 1.58, P = 0.01), 
      severe tricuspid regurgitation (HR 1.84, P = 0.003), and procedural failure 
      (defined as operator-reported failure, conversion to surgery, failure of clip 
      placement, or residual post-procedural severe mitral regurgitation) (HR 4.36, P < 
      0.0001). CONCLUSIONS: Treatment of significant MR with MitraClip resulted in 
      significant clinical improvements in a high proportion of TRAMI patients after 12 
      months. In the TRAMI cohort, the failure of procedural success exhibited the 
      highest hazard ratio concerning the prediction of 1-year mortality.
CI  - (c) The Author 2015. Published by Oxford University Press on behalf of the European 
      Society of Cardiology.
FAU - Puls, Miriam
AU  - Puls M
AD  - Herzzentrum, Georg-August-Universitat Gottingen, Gottingen, Germany 
      dr.m.puls@med.uni-goettingen.de.
FAU - Lubos, Edith
AU  - Lubos E
AD  - Universitares Herzzentrum Eppendorf Hamburg, Hamburg, Germany.
FAU - Boekstegers, Peter
AU  - Boekstegers P
AD  - Klinikum Siegburg (Kardiologie und Angiologie), Siegburg, Germany.
FAU - von Bardeleben, Ralph Stephan
AU  - von Bardeleben RS
AD  - Universitatsmedizin Mainz, 2. Med. Klinik, Mainz, Germany.
FAU - Ouarrak, Taoufik
AU  - Ouarrak T
AD  - Stiftung Institut fur Herzinfarktforschung, Ludwigshafen, Germany.
FAU - Butter, Christian
AU  - Butter C
AD  - Herzzentrum Brandenburg, Bernau, Germany.
FAU - Zuern, Christine S
AU  - Zuern CS
AD  - Universitatsklinikum Tubingen, Tubingen, Germany.
FAU - Bekeredjian, Raffi
AU  - Bekeredjian R
AD  - Universitatsklinikum Heidelberg, Heidelberg, Germany.
FAU - Sievert, Horst
AU  - Sievert H
AD  - Cardio Vasculares Centrum (CVC) Frankfurt St. Katharinen, Frankfurt am Main, 
      Germany.
FAU - Nickenig, Georg
AU  - Nickenig G
AD  - Universitatsklinikum Bonn (Med. Klinik und Poliklinik II), Bonn, Germany.
FAU - Eggebrecht, Holger
AU  - Eggebrecht H
AD  - Cardioangiologisches Centrum Bethanien (CCB), Frankfurt am Main, Germany.
FAU - Senges, Jochen
AU  - Senges J
AD  - Stiftung Institut fur Herzinfarktforschung, Ludwigshafen, Germany.
FAU - Schillinger, Wolfgang
AU  - Schillinger W
AD  - Herzzentrum, Georg-August-Universitat Gottingen, Gottingen, Germany Helios 
      Albert-Schweitzer-Klinik Northeim, Northeim, Germany.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20151127
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Catheterization
MH  - Female
MH  - Heart Failure/etiology
MH  - *Heart Valve Prosthesis
MH  - Heart Valve Prosthesis Implantation/instrumentation/*methods
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Mitral Valve Annuloplasty/instrumentation/methods
MH  - Mitral Valve Insufficiency/*surgery
MH  - Quality of Life
MH  - Registries
MH  - Treatment Outcome
PMC - PMC4761401
OTO - NOTNLM
OT  - Heart failure
OT  - MitraClip
OT  - Mitral valve regurgitation
OT  - Percutaneous mitral valve repair
OT  - TRAMI registry
EDAT- 2015/11/29 06:00
MHDA- 2017/01/04 06:00
PMCR- 2015/11/27
CRDT- 2015/11/29 06:00
PHST- 2015/05/12 00:00 [received]
PHST- 2015/10/28 00:00 [accepted]
PHST- 2015/11/29 06:00 [entrez]
PHST- 2015/11/29 06:00 [pubmed]
PHST- 2017/01/04 06:00 [medline]
PHST- 2015/11/27 00:00 [pmc-release]
AID - ehv627 [pii]
AID - 10.1093/eurheartj/ehv627 [doi]
PST - ppublish
SO  - Eur Heart J. 2016 Feb 21;37(8):703-12. doi: 10.1093/eurheartj/ehv627. Epub 2015 
      Nov 27.