Risk factors for early mortality following transcatheter edge-to-edge repair of mitral regurgitation

Yeo YH 1 , Thong JY 2 , Tan MC 3 , Ang QX 4 , San BJ 5 , Tan BE 6 Show all authors , Chatterjee A 7 , Lee K 8

Affiliations 

  • 1 Department of Internal Medicine-Pediatrics, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA
  • 2 Shanghai Medical College, Fudan University, China
  • 3 Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ, USA; Department of Internal Medicine, New York Medical College at Saint Michael's Medical Center, Newark, NJ, USA
  • 4 Department of Internal Medicine, Sparrow Health System and Michigan State University, East Lansing, MI, USA
  • 5 AIMST University, Malaysia
  • 6 Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
  • 7 Department of Cardiovascular Medicine, University of Arizona, Tucson, AZ, USA
  • 8 Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ, USA. Electronic address: Lee.kwan@mayo.edu
Cardiovasc Revasc Med, 2024 Aug 15.
PMID: 39168760 DOI: 10.1016/j.carrev.2024.08.001

Abstract

BACKGROUND: While transcatheter edge-to-edge repair (TEER) with MitraClip is increasingly used, data on the risk stratification for assessing early mortality after this procedure are scarce.

OBJECTIVE: This study aimed to assess early mortality and analyze the risk factors of early mortality among patients who underwent TEER.

METHODS: Using the all-payer, nationally representative Nationwide Readmissions Database, our study included patients aged 18 years or older who had TEER between January 2017 and November 2020. We categorized the cohort into two groups depending on the occurrence of early mortality (death within 30 days after the procedure). Based on the ICD-10, we identified the trend of early mortality after TEER and further analyzed the risk factors associated with early mortality.

RESULTS: A total of 15,931 patients who had TEER were included; 292 (1.8 %) with early mortality and 15,639 (98.2 %) without. There was a decreasing trend in early mortality from 2.8 % in the first quarter of 2017 to 1.2 % in the fourth quarter of 2020, but it was not statistically significant (p = 0.18). In multivariable analysis, the independent risk factors for early mortality were chronic kidney disease not requiring dialysis (adjusted odds ratio [aOR]: 1.57; 95 % confidence interval [CI]: 1.11-2.22, p = 0.01), end-stage renal disease (aOR: 2.34; CI: 1.44-3.79, p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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