PMID- 30153994 OWN - NLM STAT- MEDLINE DCOM- 20190903 LR - 20190903 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 277 DP - 2019 Feb 15 TI - Long-term outcome, survival and predictors of mortality after MitraClip therapy: Results from the German Transcatheter Mitral Valve Interventions (TRAMI) registry. PG - 35-41 LID - S0167-5273(18)32310-6 [pii] LID - 10.1016/j.ijcard.2018.08.023 [doi] AB - BACKGROUND: MitraClip therapy is increasingly used in patients deemed inoperable to treat severe mitral regurgitation (MR), but long-tern data is scarce. AIMS: The multicentre, industry-independent German Transcatheter Mitral Valve Interventions (TRAMI) registry comprises the largest prospectively enrolled cohort of patients treated by MitraClip therapy. The current analysis is focusing on long-term mortality rates, cardiac rehospitalization and reintervention. METHODS AND RESULTS: Long-term follow-up (median time 1037 days) in the TRAMI registry was available for 722 patients treated at 20 German centres. Improvements in New York Heart Association (NYHA) functional class (I/II long-term: 65% vs. 1-year follow-up: 63.3%) and self-rated health-status (EuroQuol visual analogue scale [EQ VAS] long-term: 60 [50-70] vs. 1-year follow-up: 60 [50; 70]) were pertained over time. Estimated mortality rates by Kaplan-Meier method were 19.7% for 1-year, 31.9% for 2-year and 53.1% for 4-year follow-up without differences found for MR aetiology. Multivariable Cox-regression analysis identified previous aortic valve implantation (hazard ratio [HR] = 2.21; p < 0.0001), NYHA class IV (HR = 1.78; p < 0.001), prior cardiac decompensation (HR = 1.63; p < 0.001), creatinine > 1.5 mg/dl (HR = 1.63; p < 0.0001) and left ventricular ejection fraction < 30% (HR = 1.60; p < 0.001) as most predictive for long-term mortality. CONCLUSIONS: Long-term outcome in the TRAMI registry confirmed lasting clinical improvements and low intervention rates. Long-term mortality was strongly influenced by cardiac and non-cardiac co-morbidities and was found comparable for both MR aetiologies. CI - Copyright (c) 2018 Elsevier B.V. All rights reserved. FAU - Kalbacher, Daniel AU - Kalbacher D AD - Universitares Herzzentrum Hamburg Eppendorf, Germany. Electronic address: d.kalbacher@uke.de. FAU - Schafer, Ulrich AU - Schafer U AD - Universitares Herzzentrum Hamburg Eppendorf, Germany. Electronic address: u.schaefer@uke.de. FAU - V Bardeleben, R Stephan AU - V Bardeleben RS AD - Universitatsmedizin Mainz, 2. Med. Klinik, Germany. Electronic address: stephan.von_bardeleben@unimedizin-mainz.de. FAU - Eggebrecht, Holger AU - Eggebrecht H AD - Cardioangiologisches Centrum Bethanien, Frankfurt a.M., Germany. Electronic address: h.eggebrecht@ccb.de. FAU - Sievert, Horst AU - Sievert H AD - Cardio Vasc. Centrum Frankfurt St. Katharinen, Germany. FAU - Nickenig, Georg AU - Nickenig G AD - Universitatsklinikum Bonn (Med. Klinik und Poliklinik II), Germany. Electronic address: georg.nickenig@ukb.uni-bonn.de. FAU - Butter, Christian AU - Butter C AD - Herzzentrum Brandenburg, Bernau, Germany. Electronic address: c.butter@immanuel.de. FAU - May, Andreas E AU - May AE AD - Universitatsklinikum Tubingen, Germany. Electronic address: andreas.may@klinikum-memmingen.de. FAU - Bekeredjian, Raffi AU - Bekeredjian R AD - Universitatsklinikum Heidelberg, Germany. Electronic address: raffi.bekeredjian@med.uni-heidelberg.de. FAU - Ouarrak, Taoufik AU - Ouarrak T AD - Stiftung Institut fur Herzinfarktforschung, Ludwigshafen, Germany. Electronic address: ouarrak@ihf.de. FAU - Kuck, Karl-Heinz AU - Kuck KH AD - Asklepios Klinik St. Georg, Hamburg, Germany. Electronic address: k.kuck@asklepios.com. FAU - Plicht, Bjorn AU - Plicht B AD - Cardiology Clinic, Herzzentrum Westfalen, Klinikum Westfalen, Dortmund, Germany. Electronic address: bjoern.plicht@klinikum-westfalen.de. FAU - Zahn, Ralf AU - Zahn R AD - Herzzentrum Ludwigshafen, Germany. FAU - Baldus, Stephan AU - Baldus S AD - Herzzentrum Uniklinikum Koln, Germany. Electronic address: stephan.baldus@uk-koeln.de. FAU - Ince, Huseyin AU - Ince H AD - Universitatsklinikum Rostock, Germany. Electronic address: hueseyin.ince@med.uni-rostock.de. FAU - Schillinger, Wolfgang AU - Schillinger W AD - Herzzentrum, Georg-August-Universitat Gottingen, Germany. Electronic address: schiwolf@med.uni-goettingen.de. FAU - Boekstegers, Peter AU - Boekstegers P AD - Klinikum Siegburg, Germany. Electronic address: peter.boekstegers@helios-kliniken.de. FAU - Senges, Jochen AU - Senges J AD - Stiftung Institut fur Herzinfarktforschung, Ludwigshafen, Germany. Electronic address: senges@stiftung-ihf.de. FAU - Lubos, Edith AU - Lubos E AD - Universitares Herzzentrum Hamburg Eppendorf, Germany. Electronic address: e.lubos@uke.de. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20180810 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Aged MH - Aged, 80 and over MH - Cohort Studies MH - Female MH - Follow-Up Studies MH - Germany/epidemiology MH - Humans MH - Male MH - Mitral Valve Insufficiency/diagnostic imaging/*mortality/*surgery MH - Mortality/trends MH - Predictive Value of Tests MH - Prospective Studies MH - *Registries MH - Surgical Instruments/*trends MH - Time Factors MH - Transcatheter Aortic Valve Replacement/*mortality/*trends MH - Treatment Outcome OTO - NOTNLM OT - Heart failure OT - MitraClip OT - Mitral regurgitation OT - TRAMI registry EDAT- 2018/08/30 06:00 MHDA- 2019/09/04 06:00 CRDT- 2018/08/30 06:00 PHST- 2018/04/09 00:00 [received] PHST- 2018/06/19 00:00 [revised] PHST- 2018/08/08 00:00 [accepted] PHST- 2018/08/30 06:00 [pubmed] PHST- 2019/09/04 06:00 [medline] PHST- 2018/08/30 06:00 [entrez] AID - S0167-5273(18)32310-6 [pii] AID - 10.1016/j.ijcard.2018.08.023 [doi] PST - ppublish SO - Int J Cardiol. 2019 Feb 15;277:35-41. doi: 10.1016/j.ijcard.2018.08.023. Epub 2018 Aug 10.