'Promising' new data on TMVr among cancer patients

Transcatheter mitral valve repair (TMVr) is associated with “promising” short-term outcomes among patients with a history of cancer, according to new research published in the American Journal of Cardiology.[1]

The study’s authors tracked nearly 23,000 TMVr hospitalizations. All patients were treated with Abbott’s MitraClip device in the United States from 2014 to 2018, and 3.4% presented with a history of malignancy.

“Although previous studies have described the use of transcatheter aortic valve replacement in patients with malignancy, there is a paucity of data investigating outcomes of TMVr in patients with a history of cancer,” wrote first author Agam Bansal, MD, an internal medicine specialist with Cleveland Clinic, and colleagues.

Overall, patients with cancer were slightly younger and more likely to be male. Patients with cancer and without cancer had similar rates of in-hospital mortality, acute kidney injury and acute myocardial infarction after TMVr with the MitraClip device. However, patients with cancer did have higher rates of 30-day hospital readmissions (17.4% vs. 14.1%), 30-day heart failure hospitalizations (15.2% vs. 11.6%) and required blood transfusions (11.3% vs. 6.9%).

These higher 30-day readmission rates “must be weighed in the decision to pursue MitraClip,” the team wrote, “although the degree of clinical significance … is likely marginal.”

“Although current guidelines recommend MitraClip in patients with a life expectancy greater than one year, it is difficult to estimate survival especially in patients with cancer,” Bansal et al. wrote. “Additionally, symptomatic mitral regurgitation (MR) may be a rate-limiting factor in optimally managing cancers, and therefore, performing MitraClip tenably serves as a viable option to improve the functional status of patients with cancer and ultimately offer them life-prolonging cancer treatment modalities. As such, multidisciplinary decision-making by cardiologists and oncologists is warranted to evaluate the need for MitraClip in patients with cancer.”