PDF(Pubmed)
Abstract：
UNASSIGNED: Risk scores may identify patients with mitral regurgitation (MR) who are at risk for adverse events, but who may still benefit from transcatheter edge-to-edge repair (TEER). We sought to cross-validate the MitraScore and COAPT risk score to predict adverse events in patients undergoing TEER.
UNASSIGNED: MitraScore validation was carried out in the COAPT population which included 614 patients with FMR who were randomized 1:1 to guideline-directed medical therapy (GDMT) with or without TEER and were followed for 2 years. Validation of the COAPT risk score was carried out in 1007 patients from the MIVNUT registry of TEER-treated patients with both FMR and degenerative MR who were followed for a mean of 2.1 years. The predictive value was assessed using the area under the receiver operating characteristic curve (AUC) plots. The primary outcome was all-cause mortality.
UNASSIGNED: The MitraScore had fair to good predictive accuracy for mortality in the overall COAPT trial population (AUC, 0.67); its accuracy was higher in patients treated with TEER (AUC, 0.74) than GDMT alone (AUC, 0.65). The COAPT risk score had fair predictive accuracy for death in the overall MitraScore cohort (AUC, 0.64), which was similar in patients with FMR and degenerative MR (AUC, 0.64 and 0.66, respectively). There was a consistent benefit of treatment with TEER plus GDMT compared with GDMT alone in the COAPT trial population across all MitraScore risk strata.
UNASSIGNED: The COAPT risk score and MitraScore are simple tools that are useful for the prediction of 2-year mortality in patients eligible for or undergoing treatment with TEER.
UNASSIGNED: MitraScore validation was carried out in the COAPT population which included 614 patients with FMR who were randomized 1:1 to guideline-directed medical therapy (GDMT) with or without TEER and were followed for 2 years. Validation of the COAPT risk score was carried out in 1007 patients from the MIVNUT registry of TEER-treated patients with both FMR and degenerative MR who were followed for a mean of 2.1 years. The predictive value was assessed using the area under the receiver operating characteristic curve (AUC) plots. The primary outcome was all-cause mortality.
UNASSIGNED: The MitraScore had fair to good predictive accuracy for mortality in the overall COAPT trial population (AUC, 0.67); its accuracy was higher in patients treated with TEER (AUC, 0.74) than GDMT alone (AUC, 0.65). The COAPT risk score had fair predictive accuracy for death in the overall MitraScore cohort (AUC, 0.64), which was similar in patients with FMR and degenerative MR (AUC, 0.64 and 0.66, respectively). There was a consistent benefit of treatment with TEER plus GDMT compared with GDMT alone in the COAPT trial population across all MitraScore risk strata.
UNASSIGNED: The COAPT risk score and MitraScore are simple tools that are useful for the prediction of 2-year mortality in patients eligible for or undergoing treatment with TEER.
摘要：
风险评分可确定存在不良事件风险的二尖瓣反流(MR)患者。但谁仍可能从经导管边缘到边缘修复（TEER）中受益。我们试图交叉验证MitraScore和COAPT风险评分，以预测接受TEER的患者的不良事件。
■在COAPT人群中进行了MitraScore验证，其中包括614名FMR患者，他们以1：1的比例随机接受有或没有TEER的指南指导的药物治疗（GDMT），并随访2年。在接受TEER治疗的FMR和退行性MR患者的MIVNUT注册表中，对1007名患者进行了COAPT风险评分的验证，这些患者平均随访2.1年。使用接受者工作特征曲线下面积(AUC)图来评估预测值。主要结果是全因死亡率。
■MitraScore对总体COAPT试验人群的死亡率具有相当好的预测准确性(AUC，0.67）；在接受TEER治疗的患者中，其准确性更高（AUC，0.74）比单独的GDMT（AUC，0.65)。在整个MitraScore队列中，COAPT风险评分对死亡具有公平的预测准确性(AUC，0.64),这在FMR和退行性MR患者中相似(AUC，分别为0.64和0.66）。在所有MitraScore风险层的COAPT试验人群中，与单独使用GDMT相比，TEER加GDMT治疗具有一致的益处。
COAPT风险评分和MitraScore是简单的工具，可用于预测符合或接受TEER治疗的患者的2年死亡率。
■在COAPT人群中进行了MitraScore验证，其中包括614名FMR患者，他们以1：1的比例随机接受有或没有TEER的指南指导的药物治疗（GDMT），并随访2年。在接受TEER治疗的FMR和退行性MR患者的MIVNUT注册表中，对1007名患者进行了COAPT风险评分的验证，这些患者平均随访2.1年。使用接受者工作特征曲线下面积(AUC)图来评估预测值。主要结果是全因死亡率。
■MitraScore对总体COAPT试验人群的死亡率具有相当好的预测准确性(AUC，0.67）；在接受TEER治疗的患者中，其准确性更高（AUC，0.74）比单独的GDMT（AUC，0.65)。在整个MitraScore队列中，COAPT风险评分对死亡具有公平的预测准确性(AUC，0.64),这在FMR和退行性MR患者中相似(AUC，分别为0.64和0.66）。在所有MitraScore风险层的COAPT试验人群中，与单独使用GDMT相比，TEER加GDMT治疗具有一致的益处。
COAPT风险评分和MitraScore是简单的工具，可用于预测符合或接受TEER治疗的患者的2年死亡率。
