Tags

Type your tag names separated by a space and hit enter

Long-term outcome, survival and predictors of mortality after MitraClip therapy: Results from the German Transcatheter Mitral Valve Interventions (TRAMI) registry.
Int J Cardiol. 2019 Feb 15; 277:35-41.IJ

Abstract

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.

Authors+Show Affiliations

Universitäres Herzzentrum Hamburg Eppendorf, Germany. Electronic address: d.kalbacher@uke.de.Universitäres Herzzentrum Hamburg Eppendorf, Germany. Electronic address: u.schaefer@uke.de.Universitätsmedizin Mainz, 2. Med. Klinik, Germany. Electronic address: stephan.von_bardeleben@unimedizin-mainz.de.Cardioangiologisches Centrum Bethanien, Frankfurt a.M., Germany. Electronic address: h.eggebrecht@ccb.de.Cardio Vasc. Centrum Frankfurt St. Katharinen, Germany.Universitätsklinikum Bonn (Med. Klinik und Poliklinik II), Germany. Electronic address: georg.nickenig@ukb.uni-bonn.de.Herzzentrum Brandenburg, Bernau, Germany. Electronic address: c.butter@immanuel.de.Universitätsklinikum Tübingen, Germany. Electronic address: andreas.may@klinikum-memmingen.de.Universitätsklinikum Heidelberg, Germany. Electronic address: raffi.bekeredjian@med.uni-heidelberg.de.Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany. Electronic address: ouarrak@ihf.de.Asklepios Klinik St. Georg, Hamburg, Germany. Electronic address: k.kuck@asklepios.com.Cardiology Clinic, Herzzentrum Westfalen, Klinikum Westfalen, Dortmund, Germany. Electronic address: bjoern.plicht@klinikum-westfalen.de.Herzzentrum Ludwigshafen, Germany.Herzzentrum Uniklinikum Köln, Germany. Electronic address: stephan.baldus@uk-koeln.de.Universitätsklinikum Rostock, Germany. Electronic address: hueseyin.ince@med.uni-rostock.de.Herzzentrum, Georg-August-Universität Göttingen, Germany. Electronic address: schiwolf@med.uni-goettingen.de.Klinikum Siegburg, Germany. Electronic address: peter.boekstegers@helios-kliniken.de.Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany. Electronic address: senges@stiftung-ihf.de.Universitäres Herzzentrum Hamburg Eppendorf, Germany. Electronic address: e.lubos@uke.de.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

30153994

Citation

Kalbacher, Daniel, et al. "Long-term Outcome, Survival and Predictors of Mortality After MitraClip Therapy: Results From the German Transcatheter Mitral Valve Interventions (TRAMI) Registry." International Journal of Cardiology, vol. 277, 2019, pp. 35-41.
Kalbacher D, Schäfer U, V Bardeleben RS, et al. Long-term outcome, survival and predictors of mortality after MitraClip therapy: Results from the German Transcatheter Mitral Valve Interventions (TRAMI) registry. Int J Cardiol. 2019;277:35-41.
Kalbacher, D., Schäfer, U., V Bardeleben, R. S., Eggebrecht, H., Sievert, H., Nickenig, G., Butter, C., May, A. E., Bekeredjian, R., Ouarrak, T., Kuck, K. H., Plicht, B., Zahn, R., Baldus, S., Ince, H., Schillinger, W., Boekstegers, P., Senges, J., & Lubos, E. (2019). Long-term outcome, survival and predictors of mortality after MitraClip therapy: Results from the German Transcatheter Mitral Valve Interventions (TRAMI) registry. International Journal of Cardiology, 277, 35-41. https://doi.org/10.1016/j.ijcard.2018.08.023
Kalbacher D, et al. Long-term Outcome, Survival and Predictors of Mortality After MitraClip Therapy: Results From the German Transcatheter Mitral Valve Interventions (TRAMI) Registry. Int J Cardiol. 2019 Feb 15;277:35-41. PubMed PMID: 30153994.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcome, survival and predictors of mortality after MitraClip therapy: Results from the German Transcatheter Mitral Valve Interventions (TRAMI) registry. AU - Kalbacher,Daniel, AU - Schäfer,Ulrich, AU - V Bardeleben,R Stephan, AU - Eggebrecht,Holger, AU - Sievert,Horst, AU - Nickenig,Georg, AU - Butter,Christian, AU - May,Andreas E, AU - Bekeredjian,Raffi, AU - Ouarrak,Taoufik, AU - Kuck,Karl-Heinz, AU - Plicht,Björn, AU - Zahn,Ralf, AU - Baldus,Stephan, AU - Ince,Hüseyin, AU - Schillinger,Wolfgang, AU - Boekstegers,Peter, AU - Senges,Jochen, AU - Lubos,Edith, Y1 - 2018/08/10/ PY - 2018/04/09/received PY - 2018/06/19/revised PY - 2018/08/08/accepted PY - 2018/8/30/pubmed PY - 2019/9/4/medline PY - 2018/8/30/entrez KW - Heart failure KW - MitraClip KW - Mitral regurgitation KW - TRAMI registry SP - 35 EP - 41 JF - International journal of cardiology JO - Int. J. Cardiol. VL - 277 N2 - 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. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/30153994/Long_term_outcome_survival_and_predictors_of_mortality_after_MitraClip_therapy:_Results_from_the_German_Transcatheter_Mitral_Valve_Interventions__TRAMI__registry_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(18)32310-6 DB - PRIME DP - Unbound Medicine ER -