Use of MitraClip for mitral valve repair in patients with acute mitral regurgitation following acute myocardial infarction: Effect of cardiogenic shock on outcomes (IREMMI Registry)

Rodrigo Estévez-Loureiro; Mony Shuvy; Maurizio Taramasso; Tomas Benito-Gonzalez; Paolo Denti; Dabit Arzamendi; Marianna Adamo; Xavier Freixa; Pedro Villablanca; Lian Krivoshei; Neil Fam; Konstantinos Spargias; Andrew Czarnecki; Dan Haberman; Yoram Agmon; Doron Sudarsky; Isaac Pascual; Vlasis Ninios; Salvatore Scianna; Igal Moaraf; Davide Schiavi; Michael Chrissoheris; Ronen Beeri; Arthur Kerner; Estefanía Fernández-Peregrina; Mattia Di Pasquale; Ander Regueiro; Lion Poles; Andres Iñiguez-Romo; Felipe Fernández-Vázquez; Francesco Maisano

doi:10.1002/ccd.29552

Use of MitraClip for mitral valve repair in patients with acute mitral regurgitation following acute myocardial infarction: Effect of cardiogenic shock on outcomes (IREMMI Registry)

Rodrigo Estévez-Loureiro^*, Mony Shuvy, Maurizio Taramasso, Tomas Benito-Gonzalez, Paolo Denti, Dabit Arzamendi, Marianna Adamo, Xavier Freixa, Pedro Villablanca, Lian Krivoshei, Neil Fam, Konstantinos Spargias, Andrew Czarnecki, Dan Haberman, Yoram Agmon, Doron Sudarsky, Isaac Pascual, Vlasis Ninios, Salvatore Scianna, Igal MoarafDavide Schiavi, Michael Chrissoheris, Ronen Beeri, Arthur Kerner, Estefanía Fernández-Peregrina, Mattia Di Pasquale, Ander Regueiro, Lion Poles, Andres Iñiguez-Romo, Felipe Fernández-Vázquez, Francesco Maisano

^*Corresponding author for this work

Faculty of Medicine

Research output: Contribution to journal › Article › peer-review

37 Scopus citations

Abstract

Objectives: To assess outcomes in patients with acute mitral regurgitation (MR) following acute myocardial infarction (AMI) who received percutaneous mitral valve repair (PMVR) with the MitraClip device and to compare outcomes of patients who developed cardiogenic shock (CS) to those who did not (non-CS). Background: Acute MR after AMI may lead to CS and is associated with high mortality. Methods: This registry analyzed patients with MR after AMI who were treated with MitraClip at 18 centers within eight countries between January 2016 and February 2020. Patients were stratified into CS and non-CS groups. Primary outcomes were mortality and rehospitalization due to heart failure. Secondary outcomes were acute procedural success, functional improvement, and MR reduction. Multivariable Cox regression analysis evaluated association of CS with clinical outcomes. Results: Among 93 patients analyzed (age 70.3 ± 10.2 years), 50 patients (53.8%) experienced CS before PMVR. Mortality at 30 days (10% CS vs. 2.3% non-CS; p =.212) did not differ between groups. After median follow-up of 7 months (IQR 2.5–17 months), the combined event mortality/re-hospitalization was similar (28% CS vs. 25.6% non-CS; p =.793). Likewise, immediate procedural success (90% CS vs. 93% non-CS; p =.793) and need for reintervention (CS 6% vs. non-CS 2.3%, p =.621) or re-admission due to HF (CS 13% vs. NCS 23%, p =.253) at 3 months did not differ. CS was not independently associated with the combined end-point (hazard ratio 1.1; 95% CI, 0.3–4.6; p =.889). Conclusions: Patients found to have significant MR during their index hospitalization for AMI had similar clinical outcomes with PMVR whether they presented in or out of cardiogenic shock, provided initial hemodynamic stabilization was first achieved before PMVR.

Original language	English
Pages (from-to)	1259-1267
Number of pages	9
Journal	Catheterization and Cardiovascular Interventions
Volume	97
Issue number	6
DOIs	https://doi.org/10.1002/ccd.29552
State	Published - 1 May 2021

Bibliographical note

Funding Information:
Rodrigo Estévez‐Loureiro is consultant for Abbott Vascular and Boston Scientific. Dr. Taramasso is a consultant for Abbott Vascular, Boston Scientific, 4TECH, and CoreMedic; and has received speaker honoraria from Edwards Lifesciences. Dr. Denti has served as a consultant for Abbott Vascular, 4Tech, Neovasc, and InnovHeart; and has received honoraria from Abbott. Dabit Arzamendi is consultant for Abbott Vascular. Dr. Xavier Freixa is consultants for Abbott Vascular. Dr. Fam, has received speaker honoraria and travel or grant support from Edwards Lifesciences Francesco Maisano received Grant and/or Research Support from Abbott, Medtronic, Edwards Lifesciences, Biotronik, Boston Scientific Corporation, NVT, Terumo; receives Consulting fees, Honoraria from Abbott, Medtronic, Edwards Lifesciences, Swissvortex, Perifect, Xeltis, Transseptal solutions, Cardiovalve, Magenta; has Royalty Income/IP Rights Edwards Lifesciencesand is Shareholder of Cardiovalve, Cardiogard, Magenta, SwissVortex, Transseptalsolutions, 4Tech, Perifect. All other authors have reported that they have no relationships relevant to the contents of this article to disclose.

Publisher Copyright:
© 2021 Wiley Periodicals LLC.

Keywords

MitraClip
acute myocardial infarction
cardiogenic shock
mitral regurgitation
percutaneous mitral valve repair

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1002/ccd.29552

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Estévez-Loureiro, R., Shuvy, M., Taramasso, M., Benito-Gonzalez, T., Denti, P., Arzamendi, D., Adamo, M., Freixa, X., Villablanca, P., Krivoshei, L., Fam, N., Spargias, K., Czarnecki, A., Haberman, D., Agmon, Y., Sudarsky, D., Pascual, I., Ninios, V., Scianna, S., ... Maisano, F. (2021). Use of MitraClip for mitral valve repair in patients with acute mitral regurgitation following acute myocardial infarction: Effect of cardiogenic shock on outcomes (IREMMI Registry). Catheterization and Cardiovascular Interventions, 97(6), 1259-1267. https://doi.org/10.1002/ccd.29552

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abstract = "Objectives: To assess outcomes in patients with acute mitral regurgitation (MR) following acute myocardial infarction (AMI) who received percutaneous mitral valve repair (PMVR) with the MitraClip device and to compare outcomes of patients who developed cardiogenic shock (CS) to those who did not (non-CS). Background: Acute MR after AMI may lead to CS and is associated with high mortality. Methods: This registry analyzed patients with MR after AMI who were treated with MitraClip at 18 centers within eight countries between January 2016 and February 2020. Patients were stratified into CS and non-CS groups. Primary outcomes were mortality and rehospitalization due to heart failure. Secondary outcomes were acute procedural success, functional improvement, and MR reduction. Multivariable Cox regression analysis evaluated association of CS with clinical outcomes. Results: Among 93 patients analyzed (age 70.3 ± 10.2 years), 50 patients (53.8%) experienced CS before PMVR. Mortality at 30 days (10% CS vs. 2.3% non-CS; p =.212) did not differ between groups. After median follow-up of 7 months (IQR 2.5–17 months), the combined event mortality/re-hospitalization was similar (28% CS vs. 25.6% non-CS; p =.793). Likewise, immediate procedural success (90% CS vs. 93% non-CS; p =.793) and need for reintervention (CS 6% vs. non-CS 2.3%, p =.621) or re-admission due to HF (CS 13% vs. NCS 23%, p =.253) at 3 months did not differ. CS was not independently associated with the combined end-point (hazard ratio 1.1; 95% CI, 0.3–4.6; p =.889). Conclusions: Patients found to have significant MR during their index hospitalization for AMI had similar clinical outcomes with PMVR whether they presented in or out of cardiogenic shock, provided initial hemodynamic stabilization was first achieved before PMVR.",

keywords = "MitraClip, acute myocardial infarction, cardiogenic shock, mitral regurgitation, percutaneous mitral valve repair",

author = "Rodrigo Est{\'e}vez-Loureiro and Mony Shuvy and Maurizio Taramasso and Tomas Benito-Gonzalez and Paolo Denti and Dabit Arzamendi and Marianna Adamo and Xavier Freixa and Pedro Villablanca and Lian Krivoshei and Neil Fam and Konstantinos Spargias and Andrew Czarnecki and Dan Haberman and Yoram Agmon and Doron Sudarsky and Isaac Pascual and Vlasis Ninios and Salvatore Scianna and Igal Moaraf and Davide Schiavi and Michael Chrissoheris and Ronen Beeri and Arthur Kerner and Estefan{\'i}a Fern{\'a}ndez-Peregrina and {Di Pasquale}, Mattia and Ander Regueiro and Lion Poles and Andres I{\~n}iguez-Romo and Felipe Fern{\'a}ndez-V{\'a}zquez and Francesco Maisano",

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year = "2021",

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day = "1",

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Estévez-Loureiro, R, Shuvy, M, Taramasso, M, Benito-Gonzalez, T, Denti, P, Arzamendi, D, Adamo, M, Freixa, X, Villablanca, P, Krivoshei, L, Fam, N, Spargias, K, Czarnecki, A, Haberman, D, Agmon, Y, Sudarsky, D, Pascual, I, Ninios, V, Scianna, S, Moaraf, I, Schiavi, D, Chrissoheris, M, Beeri, R, Kerner, A, Fernández-Peregrina, E, Di Pasquale, M, Regueiro, A, Poles, L, Iñiguez-Romo, A, Fernández-Vázquez, F & Maisano, F 2021, 'Use of MitraClip for mitral valve repair in patients with acute mitral regurgitation following acute myocardial infarction: Effect of cardiogenic shock on outcomes (IREMMI Registry)', Catheterization and Cardiovascular Interventions, vol. 97, no. 6, pp. 1259-1267. https://doi.org/10.1002/ccd.29552

Use of MitraClip for mitral valve repair in patients with acute mitral regurgitation following acute myocardial infarction: Effect of cardiogenic shock on outcomes (IREMMI Registry). / Estévez-Loureiro, Rodrigo; Shuvy, Mony; Taramasso, Maurizio et al.
In: Catheterization and Cardiovascular Interventions, Vol. 97, No. 6, 01.05.2021, p. 1259-1267.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Use of MitraClip for mitral valve repair in patients with acute mitral regurgitation following acute myocardial infarction

T2 - Effect of cardiogenic shock on outcomes (IREMMI Registry)

AU - Estévez-Loureiro, Rodrigo

AU - Shuvy, Mony

AU - Taramasso, Maurizio

AU - Benito-Gonzalez, Tomas

AU - Denti, Paolo

AU - Arzamendi, Dabit

AU - Adamo, Marianna

AU - Freixa, Xavier

AU - Villablanca, Pedro

AU - Krivoshei, Lian

AU - Fam, Neil

AU - Spargias, Konstantinos

AU - Czarnecki, Andrew

AU - Haberman, Dan

AU - Agmon, Yoram

AU - Sudarsky, Doron

AU - Pascual, Isaac

AU - Ninios, Vlasis

AU - Scianna, Salvatore

AU - Moaraf, Igal

AU - Schiavi, Davide

AU - Chrissoheris, Michael

AU - Beeri, Ronen

AU - Kerner, Arthur

AU - Fernández-Peregrina, Estefanía

AU - Di Pasquale, Mattia

AU - Regueiro, Ander

AU - Poles, Lion

AU - Iñiguez-Romo, Andres

AU - Fernández-Vázquez, Felipe

AU - Maisano, Francesco

PY - 2021/5/1

Y1 - 2021/5/1

N2 - Objectives: To assess outcomes in patients with acute mitral regurgitation (MR) following acute myocardial infarction (AMI) who received percutaneous mitral valve repair (PMVR) with the MitraClip device and to compare outcomes of patients who developed cardiogenic shock (CS) to those who did not (non-CS). Background: Acute MR after AMI may lead to CS and is associated with high mortality. Methods: This registry analyzed patients with MR after AMI who were treated with MitraClip at 18 centers within eight countries between January 2016 and February 2020. Patients were stratified into CS and non-CS groups. Primary outcomes were mortality and rehospitalization due to heart failure. Secondary outcomes were acute procedural success, functional improvement, and MR reduction. Multivariable Cox regression analysis evaluated association of CS with clinical outcomes. Results: Among 93 patients analyzed (age 70.3 ± 10.2 years), 50 patients (53.8%) experienced CS before PMVR. Mortality at 30 days (10% CS vs. 2.3% non-CS; p =.212) did not differ between groups. After median follow-up of 7 months (IQR 2.5–17 months), the combined event mortality/re-hospitalization was similar (28% CS vs. 25.6% non-CS; p =.793). Likewise, immediate procedural success (90% CS vs. 93% non-CS; p =.793) and need for reintervention (CS 6% vs. non-CS 2.3%, p =.621) or re-admission due to HF (CS 13% vs. NCS 23%, p =.253) at 3 months did not differ. CS was not independently associated with the combined end-point (hazard ratio 1.1; 95% CI, 0.3–4.6; p =.889). Conclusions: Patients found to have significant MR during their index hospitalization for AMI had similar clinical outcomes with PMVR whether they presented in or out of cardiogenic shock, provided initial hemodynamic stabilization was first achieved before PMVR.

AB - Objectives: To assess outcomes in patients with acute mitral regurgitation (MR) following acute myocardial infarction (AMI) who received percutaneous mitral valve repair (PMVR) with the MitraClip device and to compare outcomes of patients who developed cardiogenic shock (CS) to those who did not (non-CS). Background: Acute MR after AMI may lead to CS and is associated with high mortality. Methods: This registry analyzed patients with MR after AMI who were treated with MitraClip at 18 centers within eight countries between January 2016 and February 2020. Patients were stratified into CS and non-CS groups. Primary outcomes were mortality and rehospitalization due to heart failure. Secondary outcomes were acute procedural success, functional improvement, and MR reduction. Multivariable Cox regression analysis evaluated association of CS with clinical outcomes. Results: Among 93 patients analyzed (age 70.3 ± 10.2 years), 50 patients (53.8%) experienced CS before PMVR. Mortality at 30 days (10% CS vs. 2.3% non-CS; p =.212) did not differ between groups. After median follow-up of 7 months (IQR 2.5–17 months), the combined event mortality/re-hospitalization was similar (28% CS vs. 25.6% non-CS; p =.793). Likewise, immediate procedural success (90% CS vs. 93% non-CS; p =.793) and need for reintervention (CS 6% vs. non-CS 2.3%, p =.621) or re-admission due to HF (CS 13% vs. NCS 23%, p =.253) at 3 months did not differ. CS was not independently associated with the combined end-point (hazard ratio 1.1; 95% CI, 0.3–4.6; p =.889). Conclusions: Patients found to have significant MR during their index hospitalization for AMI had similar clinical outcomes with PMVR whether they presented in or out of cardiogenic shock, provided initial hemodynamic stabilization was first achieved before PMVR.

KW - MitraClip

KW - acute myocardial infarction

KW - cardiogenic shock

KW - mitral regurgitation

KW - percutaneous mitral valve repair

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Estévez-Loureiro R, Shuvy M, Taramasso M, Benito-Gonzalez T, Denti P, Arzamendi D et al. Use of MitraClip for mitral valve repair in patients with acute mitral regurgitation following acute myocardial infarction: Effect of cardiogenic shock on outcomes (IREMMI Registry). Catheterization and Cardiovascular Interventions. 2021 May 1;97(6):1259-1267. doi: 10.1002/ccd.29552

Use of MitraClip for mitral valve repair in patients with acute mitral regurgitation following acute myocardial infarction: Effect of cardiogenic shock on outcomes (IREMMI Registry)

Abstract

Bibliographical note

Keywords

UN SDGs

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