TEER shows potential to boost outcomes for cardiogenic shock patients
Transcatheter edge-to-edge repair (TEER) with the MitraClip device can boost short-term outcomes for patients with cardiogenic shock (CS) and significant mitral regurgitation (MR), according to new research published in JACC: Cardiovascular Interventions.
CS with MR has been linked to a heightened risk of morbidity and mortality, the study’s authors explained. To evaluate the effectiveness of TEER with Abbott Vascular’s MitraClip as a treatment option, they tracked data from more than 600 patients who underwent the procedure from 2014 to 2018. All data came from the Nationwide Readmissions Database.
Nearly 60% of patients were male, and the median patient age was 73 years old. An acute myocardial infarction (AMI) had been experienced by 28% of the cohort. The AMI patients were more likely to require mechanical circulatory support (MCS) and have a history of coronary artery disease. They were less likely to have atrial fibrillation.
Importantly, the rate of in-hospital mortality was higher among AMI patients (29.6% vs. 20.4%). These numbers represent a significant improvement compared to results of another recent study that found an in-hospital mortality rate of 55% to 60% among AMI patients with severe MR.
“It is not entirely clear why patients in the non-AMI group had better survival than their counterparts with AMI,” wrote lead author Medhat Farwati, MD, a specialist with Cleveland Clinic, and colleagues. “Although most baseline characteristics of the AMI and non-AMI groups were similar, MCS use was substantially lower in the latter group compared with those with AMI. This probably indicates a more favorable hemodynamic profile in the non-AMI group and thus may result in improved survival.”
The team did note that 30-day readmission rates were comparable between AMI and non-AMI patients.
“Our data suggest that TEER with MitraClip in patients with CS and significant MR, although associated with high mortality and readmission rates, maybe a reasonable therapeutic option in this highly morbid population and may improve short-term outcomes,” Farwati et al. wrote. “However, more data are needed to evaluate relative efficacy of this treatment compared with other options in these very high-risk patients.”
Read the full research letter here.
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.