PMID- 30178493
OWN - NLM
STAT- MEDLINE
DCOM- 20190521
LR  - 20190521
IS  - 1879-0844 (Electronic)
IS  - 1388-9842 (Linking)
VI  - 21
IP  - 2
DP  - 2019 Feb
TI  - Predictors of rehospitalization after percutaneous edge-to-edge mitral valve 
      repair by MitraClip implantation.
PG  - 182-192
LID - 10.1002/ejhf.1289 [doi]
AB  - BACKGROUND: In patients at increased surgical risk, transcatheter edge-to-edge 
      mitral valve repair by MitraClip implantation for severe mitral regurgitation 
      (MR) has proven to relieve symptoms of MR, reduce New York Heart Association 
      (NYHA) functional class and improve quality of life. Rehospitalization for 
      decompensated heart failure occurs frequently after MitraClip implantation, 
      negatively impacting quality of life. We aimed here to determine predictors of 
      1-year rehospitalization for decompensated heart failure. METHODS AND RESULTS: A 
      total of 355 consecutive patients who underwent MitraClip implantation at our 
      centre were evaluated for their baseline and procedural characteristics, 
      peri-procedural outcome and clinical endpoints. Rate of rehospitalization for 
      decompensated heart failure was reduced from 52.7% (n = 187) in the year before 
      MitraClip procedure to 18.0% (n = 64) (P < 0.0001) in the first year after 
      MitraClip implantation. The mean duration until rehospitalization was 117 days 
      after MitraClip implantation. Multivariate Cox proportional hazards regression 
      analysis identified baseline left ventricular ejection fraction (P = 0.020), 
      baseline troponin T (P = 0.003) and pre-procedural NYHA class (P = 0.020) as 
      independent predictors for 1-year rehospitalization after MitraClip implantation. 
      Rehospitalization correlated significantly with all-cause mortality (odds ratio 
      2.3, 95% confidence interval 1.3-4.1; P = 0.004) and cardiovascular mortality 
      (odds ratio 3.3, 95% confidence interval 1.7-6.1; P = 0.0003). CONCLUSION: After 
      MitraClip implantation, annual rate of rehospitalization for decompensated heart 
      failure was reduced by 65.8%. Baseline left ventricular ejection fraction, 
      baseline troponin T and pre-procedural NYHA functional class are independent 
      predictors for rehospitalization within the first year after MitraClip 
      implantation. Patients readmitted for decompensated heart failure after MitraClip 
      implantation had a 2.3-fold increased risk of all-cause mortality and a 3.3-fold 
      increased risk of cardiovascular mortality compared to patients not requiring 
      rehospitalization.
CI  - (c) 2018 The Authors. European Journal of Heart Failure (c) 2018 European Society of 
      Cardiology.
FAU - Kessler, Mirjam
AU  - Kessler M
AD  - Department of Internal Medicine II, University of Ulm, Ulm, Germany.
FAU - Seeger, Julia
AU  - Seeger J
AD  - Department of Internal Medicine II, University of Ulm, Ulm, Germany.
FAU - Muche, Rainer
AU  - Muche R
AD  - Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.
FAU - Wohrle, Jochen
AU  - Wohrle J
AD  - Department of Internal Medicine II, University of Ulm, Ulm, Germany.
FAU - Rottbauer, Wolfgang
AU  - Rottbauer W
AD  - Department of Internal Medicine II, University of Ulm, Ulm, Germany.
FAU - Markovic, Sinisa
AU  - Markovic S
AD  - Department of Internal Medicine II, University of Ulm, Ulm, Germany.
LA  - eng
PT  - Journal Article
DEP - 20180903
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
SB  - IM
CIN - Eur J Heart Fail. 2019 Feb;21(2):193-195. PMID: 30672075
MH  - Aged
MH  - Cardiac Catheterization/*methods
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Valve Prosthesis Implantation/*methods
MH  - Humans
MH  - Male
MH  - Mitral Valve/*surgery
MH  - Mitral Valve Insufficiency/diagnosis/physiopathology/*surgery
MH  - Patient Readmission/*trends
MH  - Prognosis
MH  - Prospective Studies
MH  - Prosthesis Design
MH  - Severity of Illness Index
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Function, Left/*physiology
OTO - NOTNLM
OT  - Heart failure
OT  - MitraClip
OT  - Rehospitalization
EDAT- 2018/09/05 06:00
MHDA- 2019/05/22 06:00
CRDT- 2018/09/05 06:00
PHST- 2018/03/20 00:00 [received]
PHST- 2018/06/08 00:00 [revised]
PHST- 2018/07/03 00:00 [accepted]
PHST- 2018/09/05 06:00 [pubmed]
PHST- 2019/05/22 06:00 [medline]
PHST- 2018/09/05 06:00 [entrez]
AID - 10.1002/ejhf.1289 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2019 Feb;21(2):182-192. doi: 10.1002/ejhf.1289. Epub 2018 Sep 
      3.