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The MitraClip and survival in patients with mitral regurgitation at high risk for surgery: A propensity-matched comparison.

Publication ,  Journal Article
Velazquez, EJ; Samad, Z; Al-Khalidi, HR; Sangli, C; Grayburn, PA; Massaro, JM; Stevens, SR; Feldman, TE; Krucoff, MW
Published in: Am Heart J
November 2015

BACKGROUND: We compared 30-day and 1-year survival among high-risk mitral regurgitation (MR) patients treated with the MitraClip (Abbott Vascular, Abbott Park, IL) with matched non-surgically treated patients from the Duke Echocardiography Laboratory Database (DELD). METHODS AND RESULTS: High-risk patients with 3+/4+ MR managed non-surgically between years 2000 and 2010 in the longitudinal DELD were matched to high-risk MitraClip patients. Patient matching was performed using the method of nearest available Mahalanobis distance metric within calipers defined by the propensity score. Kaplan-Meier estimates and stratified Cox proportional hazards models were used to compare survival at 30 days and 1 year. Among 953 high-risk DELD patients available for matching, 30-day and 1-year mortality were 6.5% and 26.2%. Close matches were obtained for 239 of the 351 MitraClip patients. The 30-day mortality in MitraClip patients was lower (4.2%) when compared with matched DELD patients (7.2%). The 1-year relative risk of mortality of the MitraClip compared with non-surgical treatment was 0.64 (95% CI 0.45-0.91; log-rank P = .013). These results in favor of the MitraClip remained significant upon further adjustment for baseline differences between groups (P = .043). CONCLUSIONS: This matched comparison of severe MR patients at high surgical risk supports the safety of the MitraClip relative to medical therapy at 30 days and a survival benefit at 1 year.

Duke Scholars

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Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

November 2015

Volume

170

Issue

5

Start / End Page

1050 / 1059.e3

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Survival Rate
  • Risk Assessment
  • Retrospective Studies
  • Prosthesis Design
  • Proportional Hazards Models
  • Mitral Valve Insufficiency
  • Mitral Valve
  • Male
 

Citation

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Velazquez, E. J., Samad, Z., Al-Khalidi, H. R., Sangli, C., Grayburn, P. A., Massaro, J. M., … Krucoff, M. W. (2015). The MitraClip and survival in patients with mitral regurgitation at high risk for surgery: A propensity-matched comparison. Am Heart J, 170(5), 1050-1059.e3. https://doi.org/10.1016/j.ahj.2015.08.004
Velazquez, Eric J., Zainab Samad, Hussein R. Al-Khalidi, Chithra Sangli, Paul A. Grayburn, Joseph M. Massaro, Susanna R. Stevens, Ted E. Feldman, and Mitchell W. Krucoff. “The MitraClip and survival in patients with mitral regurgitation at high risk for surgery: A propensity-matched comparison.Am Heart J 170, no. 5 (November 2015): 1050-1059.e3. https://doi.org/10.1016/j.ahj.2015.08.004.
Velazquez EJ, Samad Z, Al-Khalidi HR, Sangli C, Grayburn PA, Massaro JM, et al. The MitraClip and survival in patients with mitral regurgitation at high risk for surgery: A propensity-matched comparison. Am Heart J. 2015 Nov;170(5):1050-1059.e3.
Velazquez, Eric J., et al. “The MitraClip and survival in patients with mitral regurgitation at high risk for surgery: A propensity-matched comparison.Am Heart J, vol. 170, no. 5, Nov. 2015, pp. 1050-1059.e3. Pubmed, doi:10.1016/j.ahj.2015.08.004.
Velazquez EJ, Samad Z, Al-Khalidi HR, Sangli C, Grayburn PA, Massaro JM, Stevens SR, Feldman TE, Krucoff MW. The MitraClip and survival in patients with mitral regurgitation at high risk for surgery: A propensity-matched comparison. Am Heart J. 2015 Nov;170(5):1050-1059.e3.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

November 2015

Volume

170

Issue

5

Start / End Page

1050 / 1059.e3

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Survival Rate
  • Risk Assessment
  • Retrospective Studies
  • Prosthesis Design
  • Proportional Hazards Models
  • Mitral Valve Insufficiency
  • Mitral Valve
  • Male