Health Status after Transcatheter Mitral Valve Repair in Patients with Heart Failure and Secondary Mitral Regurgitation: COAPT Trial

, Abstract Background— In the COAPT trial, transcatheter mitral valve repair (TMVr) with the edge-to-edge device led to reduced heart failure (HF) hospitalizations and improved survival in patients with symptomatic HF and 3-4+ secondary mitral regurgitation (MR) on maximally-tolerated medical therapy. Given the advanced age and comorbidities of these patients, improvement in health status is also an important treatment goal. Objective— To understand the health status outcomes of patients with HF and 3-4+ secondary MR treated with TMVr versus standard care. Methods— The COAPT trial randomized patients with HF and 3-4+ secondary MR to TMVr (n=302) or standard care (n=312). Health status was assessed at baseline and at 1, 6, 12, and 24 months with the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the SF-36 health status this prospective sub-study of the COAPT trial, we examined the disease-specific health status outcomes of patients with symptomatic HF and 3-4+ secondary mitral regurgitation randomized to transcatheter mitral valve repair (TMVr; n=302) versus standard care (n=312). Compared with standard care, patients randomized to TMVr demonstrated substantially better health status at 1 month with only slight attenuation of this benefit by 24 months. At 24 months, 36% of TMVr patients were alive with a moderately large improvement in health status vs. 17% of standard care patients (number needed to treat=5.1).