Virtual ACC 2020 | COAPT: Better Quality of Life Translates into Harder End-Points

After transcatheter mitral valve repair with MitraClip, the COAPT patients saw improved quality of life, better survival rate and fewer hospitalizations for cardiac failure at long term follow-up. 

Improved quality of life had already been presented, exactly one year ago at the ACC 2019. In that occasion, it was established that the MitraClip reduces symptoms compared against the standard treatment. 

The current analysis was meant to be presented at ACC 2020 together with the World Congress of Cardiology and published simultaneously at J Am Coll Cardiol, and though unfortunately it was impossible to carry out the official presentation due to the COVID19 pandemic, luckily this study’s contributions can reach us via the internet.

Read also: Virtual ACC 2020 | Unlike in TAVR, the Number of Mitral Valve Surgeries Does Not Improve the Outcomes of Transcatheter Mitral Valve Repairs.

The new data indicate that improved quality of life scores will over time translate into prognosis, regardless of the strategy initially employed. That is, improved quality of life would work as a kind of marker of other changes more difficult to quantify, such as anatomy, physiology and hemodynamics. Patients receiving optimal medical treatment (OMT) who saw improved quality of life would also improve at follow-up. 

The original COAPT had showed patients with cardiac failure and severe functional mitral failure had fewer hospitalizations and lower mortality rate (the latter being a secondary endpoint) at 2 years. 

The current analysis focused on 551 patients who survived one month after procedure and completed quality of life forms (279 in the MitraClip group and 272 in the OMT). Patients with MitraClip had better chance of survival, they scored over ten points higher (MitraClip 58% vs OMT 26%).

Read also: Virtual ACC 2020 | Statins Could Also Protect Against Chemotherapy Cardiotoxicity.

For every 10 points in the quality of life score [Kansas City Cardiomyopathy Questionnaire (KCCQ)] there was a 14% reduction of new hospitalization or death risk.

Original title: Health status changes and outcomes in patients with heart failure and mitral regurgitation: from COAPT. 

Reference: Arnold SV et al. J Am Coll Cardiol. 2020; Epub ahead of print.

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