TVT 2022: EXPAND registry shows benefit of MitraClip in patients outside of COAPT trial criteria

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Gilbert Tang at TVT

Analysis of the EXPAND registry, looking at one-year outcomes of MitraClip treatment in secondary mitral regurgitation (MR) patients who fall outside of the eligibility criteria of the COAPT trial has found that these patients experience “significant and durable” reductions in MR, and similar one-year clinical outcomes compared to COAPT-like patients.

The latest findings from the global EXPAND registry, the largest contemporary, real-world study of the use of the MitraClip NTR/XTR (Abbott), were presented during a late-breaking trial session at TVT 2022 (The Structural Heart Summit, 8–10 June, Chicago, USA) by Gilbert Tang (Mount Sinai Health System, New York, USA).

The present analysis of one-year clinical and functional outcomes demonstrates the benefit of MitraClip in secondary MR patients both within the eligibility criteria for Abbott’s COAPT trial—which studied symptomatic heart failure patients with moderate-to-severe or severe secondary MR—and outside COAPT eligibility, including patients with moderate at baseline MR and patients with advanced heart failure, TVT attendees heard.

The data across all patient groups through one year showed a significant MR reduction to ≤1+ MR (81.3%-97.2%), improvements in New York Heart Association (NYHA) class (a classification of functional limitations resulting from cardiac disease) and quality of life from baseline, as well as comparable all-cause mortality and heart failure hospitalisation rates.

“Doctors have been using the eligibility criteria from Abbott’s COAPT trial to identify heart failure patients with secondary MR who would benefit from MitraClip treatment,” Tang was quoted as saying in a press release published shortly after the presentation of the results by Abbott. “The real-world findings from this study show that excellent MR reduction and one-year outcomes were achieved by MitraClip not only in COAPT-like patients but also in a wider group of patients outside the COAPT criteria, meaning physicians may be able to help even more people with secondary MR. It will be interesting to continue following the progress of these heart failure patients after MitraClip therapy.”


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