Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Interventional Cardiology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil.
Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
Int J Cardiol. 2024 Apr 1;400:131768. doi: 10.1016/j.ijcard.2024.131768. Epub 2024 Jan 10.
Transcatheter edge-to-edge repair (TEER) has become an established treatment for primary and secondary mitral regurgitation (PMR and SMR). The objective of this study was to compare the accuracy of different risk scores for predicting 1-year mortality and the composite endpoint of 1-year mortality and/or heart failure (HF) hospitalization after TEER.
We analyzed data from 206 patients treated for MR at a tertiary European center between 2011 and 2023 and compared the accuracy of different mitral and surgical risk scores: EuroSCORE II, GRASP, MITRALITY, MitraScore, TAPSE/PASP-MitraScore, and STS for predicting 1-year mortality and the composite of 1-year mortality and/or HF hospitalization in PMR and SMR. A subanalysis of SMR-only patients with the addition of COAPT Risk Score and baseline N-Terminal pro-Brain Natriuretic Peptide (NT-proBNP) list was also performed.
MITRALITY had the best discriminative ability for 1-year mortality and the composite endpoint of 1-year mortality and/or HF hospitalization, with an area under the curve (AUC) of 0.74 and 0.74, respectively, in a composed group of PMR and SMR. In a SMR-only population, MITRALITY also presented the best AUC for 1-year mortality and the composite endpoint of 1-year mortality and/or HF hospitalization, with values of 0.72 and 0.72, respectively.
MITRALITY was the best mitral TEER risk model for both 1-year mortality and the composite endpoint of 1-year mortality and/or HF hospitalization in a population of PMR and SMR patients, as well as in SMR patients only. Surgical risk scores, MitraScore, TAPSE/PASP-MitraScore and NT-proBNP alone showed poor predictive values.
经导管缘对缘修复术（TEER）已成为原发性和继发性二尖瓣反流（PMR 和 SMR）的一种既定治疗方法。本研究的目的是比较不同风险评分预测 TEER 后 1 年死亡率和 1 年死亡率和/或心力衰竭（HF）住院复合终点的准确性。
我们分析了 2011 年至 2023 年在欧洲一家三级中心接受 MR 治疗的 206 例患者的数据，并比较了不同的二尖瓣和手术风险评分的准确性：欧洲心脏手术风险评分 II（EuroSCORE II）、GRASP、MITRALITY、MitraScore、TAPSE/PASP-MitraScore 和 STS，以预测 PMR 和 SMR 中 1 年死亡率和 1 年死亡率和/或 HF 住院的复合终点。还对仅 SMR 患者进行了亚分析，加入了 COAPT 风险评分和基线 N 端脑利钠肽前体（NT-proBNP）列表。
MITRALITY 在 PMR 和 SMR 综合组中，对 1 年死亡率和 1 年死亡率和/或 HF 住院的复合终点的区分能力最佳，曲线下面积（AUC）分别为 0.74 和 0.74。在仅 SMR 人群中，MITRALITY 对 1 年死亡率和 1 年死亡率和/或 HF 住院的复合终点的 AUC 也最佳，分别为 0.72 和 0.72。
MITRALITY 是 PMR 和 SMR 患者人群以及仅 SMR 患者中，预测 TEER 后 1 年死亡率和 1 年死亡率和/或 HF 住院复合终点的最佳二尖瓣 TEER 风险模型。手术风险评分、MitraScore、TAPSE/PASP-MitraScore 和 NT-proBNP 单独预测值较差。
