在COAPT-不符合条件的患者中进行过导管边缘到边缘修复,患者有功能性 mitrale 吐
Adnan K Chhatriwalla1, David J Cohen2, Sreekanth Vemulapalli3
1Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, Missouri, USA.
Journal of the American College of Cardiology
|January 24, 2024
概括
在不符合COAPT试验条件的患者中,中枢透管端到端修复 (MTEER) 显示了类似的短期健康改善,但死亡或心力衰竭住院的1年风险更高.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏衰竭管理的管理
背景情况:
- 副手透管边缘到边缘修复 (MTEER) 已被批准用于功能性副手反 (FMR).
- 批准是基于COAPT试验,该试验具有特定的纳入标准.
研究的目的:
- 分析从COAPT试验中排除的FMR患者的MTEER结果.
- 为了比较接受MTEER的COAPT不符合条件和COAPT符合条件的FMR患者之间的结果.
主要方法:
- 在TVT注册表中对FMR的MTEER程序的回顾性分析 (2013-2020).
- 根据COAPT排除标准 (例如,心脏性休克,LVEF <20%),被归类为"试验不合格"的患者.
- 使用多变量模型比较1年的结果 (死亡或心力衰竭住院).
主要成果:
- 在6675名患有FMR的MTEER患者中,近一半 (44.3%) 无法参加试验.
- 不符合试验条件的患者的技术成功率较低,住院并发症较高.
- 在两组中都观察到类似的30天健康状况改善.
结论:
- 接受MTEER的大量FMR患者将无法参加COAPT试验.
- 虽然短期健康状况同样有所改善,但试验不合格的患者面临更高的一年死亡率和心力衰竭住院率.
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