在这些情况下,我更喜欢MitraClip:五年COAPT数据
Antonio L Bartorelli1,2, Luca Grancini1, Giovanni Monizzi1
1IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan.
概括
过导管边缘到边缘修复 (TEER) 显著降低了二次 mitrale regurgitation (SMR) 患者的住院和死亡. 为了在左心室功能障碍方面获得最佳结果,需要进一步的研究.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 二次额叶吐 (SMR) 显著影响患者的预后.
- 过导管端到端修复 (TEER) 是一种新兴的SMR治疗方法.
研究的目的:
- 评估使用MitraClip设备在患有严重SMR的患者中TEER的5年结局.
- 将TEER结果与医疗管理进行比较,并分析影响COAPT和MITRA-FR等试验之间的差异因素.
主要方法:
- 来自COAPT试验的5年随访数据的分析.
- 与医疗治疗和交叉患者的TEER结果的比较.
- 探索患者特征和程序因素,使COAPT和MITRA-FR区别开来.
主要成果:
- 与医疗治疗相比,TEER在5年内将年度住院风险降低了近一半 (33%vs. 57%) 和死亡率降低了近30% (57%vs. 67%).
- 95%的患者通过TEER实现了显著和持久的SMR降低.
- 死亡或住院治疗心力衰竭发生在73.6%的TEER患者,而对照组在5年内发生在91.5%.
- 后来转向TEER的患者的预后有所改善,但在符合条件之前死亡率显著.
结论:
- 与MitraClip一起的TEER为症状严重的SMR患者提供了显著的长期益处.
- 左心室功能障碍仍然是一个关键因素,需要进一步调查和优化治疗策略.
- 患者的选择,包括左心室扩张/功能障碍的严重程度,对于成功的TEER结果至关重要,正如COAPT和MITRA-FR之间的比较所表明的那样.
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