Clinical Impact of Baseline Frailty Status and Residual Mitral Regurgitation After Transcatheter Edge‐to‐Edge Repair: Insights From the OCEAN‐Mitral Registry
Background The Clinical Frailty Scale (CFS) is a useful frailty marker for predicting clinical outcomes in patients undergoing invasive therapy. However, the clinical impact of CFS after transcatheter edge‐to‐edge repair in patients with mitral regurgitation (MR) remains unclear. This study aimed to...
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2024-11-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.035109 |
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| author | Takahiro Tokuda Masanori Yamamoto Ai Kagase Testuro Shimura Ryo Yamaguchi Mike Saji Masahiko Asami Yusuke Enta Masaki Nakashima Shinichi Shirai Masaki Izumo Shingo Mizuno Yusuke Watanabe Makoto Amaki Kazuhisa Kodama Junichi Yamaguchi Yoshifumi Nakajima Toru Naganuma Hiroki Bota Yohei Ohno Masahiro Yamawaki Hiroshi Ueno Kazuki Mizutani Toshiaki Otsuka Shunsuke Kubo Kentaro Hayashida |
| author_facet | Takahiro Tokuda Masanori Yamamoto Ai Kagase Testuro Shimura Ryo Yamaguchi Mike Saji Masahiko Asami Yusuke Enta Masaki Nakashima Shinichi Shirai Masaki Izumo Shingo Mizuno Yusuke Watanabe Makoto Amaki Kazuhisa Kodama Junichi Yamaguchi Yoshifumi Nakajima Toru Naganuma Hiroki Bota Yohei Ohno Masahiro Yamawaki Hiroshi Ueno Kazuki Mizutani Toshiaki Otsuka Shunsuke Kubo Kentaro Hayashida |
| author_sort | Takahiro Tokuda |
| collection | DOAJ |
| description | Background The Clinical Frailty Scale (CFS) is a useful frailty marker for predicting clinical outcomes in patients undergoing invasive therapy. However, the clinical impact of CFS after transcatheter edge‐to‐edge repair in patients with mitral regurgitation (MR) remains unclear. This study aimed to elucidate the association between the baseline frail status defined by the CFS and clinical outcomes with or without postprocedural MR ≥2+ (post‐MR ≥2+) after transcatheter edge‐to‐edge repair. Methods and Results Based on a Japanese multicenter registry (OCEAN [Optimized Catheter Valvular Intervention]‐Mitral), data from 2078 patients with MR who underwent transcatheter edge‐to‐edge repair were analyzed. The patients were classified into 5 groups: CFS 1 to 3, 4, 5, 6, and ≥7. The procedural and clinical outcomes and post‐MR ≥2+ were compared among the groups. All‐cause mortality for up to 2 years was explored using Cox proportional hazards regression analysis. Although the rates of acute procedural success and post‐MR ≥2+ were similar, all‐cause mortality at 2 years was significantly increased across the 5 CFS categories (15.5%, 23.8%, 27.7%, 34.6%, and 48.8%, respectively, P<0.001). The incremental CFS categories and post‐MR ≥2+ were independent predictive risk factors of all‐cause mortality (all P<0.05). Among the patients with 5 CFS categories, the incidence of all‐cause mortality was higher in those with post‐MR ≥2+ than in those without (all P<0.05). Conclusions Although prognosis was poor in patients with higher CFS grade after transcatheter edge‐to‐edge repair, minimizing modifiable factors of residual MR is warranted to improve the clinical outcomes. Registration Information URL: https://center6.umin.ac.jp/cgi‐open‐bin/ctr/ctr_view.cgi?recptno=R000027188; Unique identifier: UMIN000023653. |
| format | Article |
| id | doaj-art-7b64163d134445258b2450ea378fc93a |
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| language | English |
| publishDate | 2024-11-01 |
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| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-7b64163d134445258b2450ea378fc93a2025-08-20T01:54:22ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-11-01132110.1161/JAHA.124.035109Clinical Impact of Baseline Frailty Status and Residual Mitral Regurgitation After Transcatheter Edge‐to‐Edge Repair: Insights From the OCEAN‐Mitral RegistryTakahiro Tokuda0Masanori Yamamoto1Ai Kagase2Testuro Shimura3Ryo Yamaguchi4Mike Saji5Masahiko Asami6Yusuke Enta7Masaki Nakashima8Shinichi Shirai9Masaki Izumo10Shingo Mizuno11Yusuke Watanabe12Makoto Amaki13Kazuhisa Kodama14Junichi Yamaguchi15Yoshifumi Nakajima16Toru Naganuma17Hiroki Bota18Yohei Ohno19Masahiro Yamawaki20Hiroshi Ueno21Kazuki Mizutani22Toshiaki Otsuka23Shunsuke Kubo24Kentaro Hayashida25Department of Cardiology Nagoya Heart Center Nagoya JapanDepartment of Cardiology Nagoya Heart Center Nagoya JapanDepartment of Cardiology Nagoya Heart Center Nagoya JapanDepartment of Cardiology Gifu Heart Center Gifu JapanDepartment of Cardiology Toyohashi Heart Center Toyohashi JapanDepartment of Cardiology Sakakibara Heart Institute Tokyo JapanDivision of Cardiology Mitsui Memorial Hospital Tokyo JapanDepartment of Cardiology Sendai Kosei Hospital Sendai JapanDepartment of Cardiology Sendai Kosei Hospital Sendai JapanDivision of Cardiology Kokura Memorial Hospital Kitakyushu JapanDivision of Cardiology St. Marianna University School of Medicine Hospital Kawasaki JapanDepartment of Cardiology Shonan Kamakura General Hospital Kamakura JapanDepartment of Cardiology Teikyo University School of Medicine Tokyo JapanDepartment of Cardiology National Cerebral and Cardiovascular Center Suita JapanDivision of Cardiology Saiseikai Kumamoto Hospital Cardiovascular Center Kumamoto JapanDepartment of Cardiology Tokyo Woman’s Medical University Tokyo JapanDivision of Cardiology, Department of Internal Medicine Iwate Medical University Iwate JapanDepartment of Cardiology New Tokyo Hospital Chiba JapanDepartment of Cardiology Sapporo Higashi Tokushukai Hospital Sapporo JapanDepartment of Cardiology Tokai University School of Medicine Isehara JapanDepartment of Cardiology Saiseikai Yokohama City Eastern Hospital Yokohama JapanSecond Department of Internal Medicine Toyama University Hospital Toyama JapanDivision of Cardiology, Department of Medicine Kinki University Faculty of Medicine Osaka JapanCenter for Clinical Research Nippon Medical School Hospital Tokyo JapanDepartment of Cardiology Kurashiki Central Hospital Kurashiki JapanDepartment of Cardiology Keio University School of Medicine Tokyo JapanBackground The Clinical Frailty Scale (CFS) is a useful frailty marker for predicting clinical outcomes in patients undergoing invasive therapy. However, the clinical impact of CFS after transcatheter edge‐to‐edge repair in patients with mitral regurgitation (MR) remains unclear. This study aimed to elucidate the association between the baseline frail status defined by the CFS and clinical outcomes with or without postprocedural MR ≥2+ (post‐MR ≥2+) after transcatheter edge‐to‐edge repair. Methods and Results Based on a Japanese multicenter registry (OCEAN [Optimized Catheter Valvular Intervention]‐Mitral), data from 2078 patients with MR who underwent transcatheter edge‐to‐edge repair were analyzed. The patients were classified into 5 groups: CFS 1 to 3, 4, 5, 6, and ≥7. The procedural and clinical outcomes and post‐MR ≥2+ were compared among the groups. All‐cause mortality for up to 2 years was explored using Cox proportional hazards regression analysis. Although the rates of acute procedural success and post‐MR ≥2+ were similar, all‐cause mortality at 2 years was significantly increased across the 5 CFS categories (15.5%, 23.8%, 27.7%, 34.6%, and 48.8%, respectively, P<0.001). The incremental CFS categories and post‐MR ≥2+ were independent predictive risk factors of all‐cause mortality (all P<0.05). Among the patients with 5 CFS categories, the incidence of all‐cause mortality was higher in those with post‐MR ≥2+ than in those without (all P<0.05). Conclusions Although prognosis was poor in patients with higher CFS grade after transcatheter edge‐to‐edge repair, minimizing modifiable factors of residual MR is warranted to improve the clinical outcomes. Registration Information URL: https://center6.umin.ac.jp/cgi‐open‐bin/ctr/ctr_view.cgi?recptno=R000027188; Unique identifier: UMIN000023653.https://www.ahajournals.org/doi/10.1161/JAHA.124.035109Clinical Frailty Scaleresidual mitral regurgitationrisk stratificationtranscatheter edge‐to‐edge repair |
| spellingShingle | Takahiro Tokuda Masanori Yamamoto Ai Kagase Testuro Shimura Ryo Yamaguchi Mike Saji Masahiko Asami Yusuke Enta Masaki Nakashima Shinichi Shirai Masaki Izumo Shingo Mizuno Yusuke Watanabe Makoto Amaki Kazuhisa Kodama Junichi Yamaguchi Yoshifumi Nakajima Toru Naganuma Hiroki Bota Yohei Ohno Masahiro Yamawaki Hiroshi Ueno Kazuki Mizutani Toshiaki Otsuka Shunsuke Kubo Kentaro Hayashida Clinical Impact of Baseline Frailty Status and Residual Mitral Regurgitation After Transcatheter Edge‐to‐Edge Repair: Insights From the OCEAN‐Mitral Registry Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease Clinical Frailty Scale residual mitral regurgitation risk stratification transcatheter edge‐to‐edge repair |
| title | Clinical Impact of Baseline Frailty Status and Residual Mitral Regurgitation After Transcatheter Edge‐to‐Edge Repair: Insights From the OCEAN‐Mitral Registry |
| title_full | Clinical Impact of Baseline Frailty Status and Residual Mitral Regurgitation After Transcatheter Edge‐to‐Edge Repair: Insights From the OCEAN‐Mitral Registry |
| title_fullStr | Clinical Impact of Baseline Frailty Status and Residual Mitral Regurgitation After Transcatheter Edge‐to‐Edge Repair: Insights From the OCEAN‐Mitral Registry |
| title_full_unstemmed | Clinical Impact of Baseline Frailty Status and Residual Mitral Regurgitation After Transcatheter Edge‐to‐Edge Repair: Insights From the OCEAN‐Mitral Registry |
| title_short | Clinical Impact of Baseline Frailty Status and Residual Mitral Regurgitation After Transcatheter Edge‐to‐Edge Repair: Insights From the OCEAN‐Mitral Registry |
| title_sort | clinical impact of baseline frailty status and residual mitral regurgitation after transcatheter edge to edge repair insights from the ocean mitral registry |
| topic | Clinical Frailty Scale residual mitral regurgitation risk stratification transcatheter edge‐to‐edge repair |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.035109 |
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