New risk score predicts mortality after TEER
An international team of researchers has developed a new risk score for predicting mortality in patients treated with mitral valve leaflet transcatheter edge-to-edge repair (TEER). The group shared its findings in the Journal of the American College of Cardiology [1], noting that risk stratification for TEER has been “scarcely studied” until now.
The analysis started with Percutaneous Mitral Valve Repair and Nutritional Status Registry (MIVNUT) registry data from more than 1,100 patients with symptomatic mitral regurgitation (MR) who underwent TEER, formerly known as transcatheter mitral valve repair, from 2012 to 2020. Patients were treated at one of 12 facilities in Europe or Canada, and an interdisciplinary heart team was involved in all treatment decisions.
Reviewing these data, including all relevant outcomes, the study’s authors identified eight independent predictors of mortality: being 75 years old or older, anemia, a low glomerular filtrate rate score, left ventricular ejection fraction greater than 40%, peripheral artery disease, chronic obstructive pulmonary disease, high diuretic dose and no therapy with renin-angiotensin system (RAS) inhibitors.
The group then used these factors to develop its MitraScore prediction algorithm, noting that each point added to the MitraScore was associated with the patient’s relative risk of mortality increasing by 55%. The score was also validated using data from 725 patients originally included in the GIOTTO registry.
Overall, the team found, the MitraScore algorithm “maintained adequate discrimination and calibration in the validation cohort.” In addition to identifying patients who may face a higher risk of mortality, the score was also able to anticipate when a patient may need to be rehospitalized for heart failure.
“Our study represents an important step forward toward better and more objective risk estimation of TEER patients,” wrote first author Sergio Raposeiras-Roubin, MD, PhD, a cardiologist with University Hospital Alvaro Cunqueiro in Spain, and colleagues. “The implementation of the MitraScore in clinical practice should help heart teams in the (commonly not easy) clinical decision-making process regarding the selection of transcatheter repair candidates. However, it is important to keep in mind that risk-prediction tools are developed in populations, not individuals.”
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Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.