Impact of Natriuretic Peptide and Prior Hospitalization in Patients With Severe Mitral Regurgitation: COAPT Trial

• DOI: 10.1161/circinterventions.125.015192
• Publication Date: 2025-05-13T09:00:21Z
• Authors: Sachin S. Goel; Ashrith Guha; JoAnn Lindenfeld; William T. Abraham; Saibal Kar; Samir R. Kapadia; Stephen H. Little; D. Scott Lim; Michael J. Reardon; Neal S. Kleiman; Janani Aiyer; Lak Kotinkaduwa; Michael Mack; Gregg W. Stone
• Keywords: MitraClip; Brain natriuretic peptide

BACKGROUND: The clinical significance of elevated baseline natriuretic peptide level and prior heart failure hospitalization (HFH) within the year in mitral transcatheter edge-to-edge repair outcomes is unclear. This analysis examined impact BNP (B-type peptide) or N-terminal prohormone NT-proBNP (N-terminal pro-B-type HFH on patients with severe secondary regurgitation. METHODS: COAPT trial (Cardiovascular Outcomes Assessment MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation) was a randomized controlled subjects assigned to valve device versus guideline-directed medical therapy alone. were grouped by BNP/NT-proBNP levels 1 year: (1) Mild (HF): no BNP/NT-proBNP<median; (2) Moderate HF: BNP/NT-proBNP<median BNP/NT-proBNP≥median; (3) Severe BNP/NT-proBNP≥median. primary measures 2-year rates death HFH. RESULTS: Of 572 patients, mild, moderate, HF present 125 (21.9%), 288 (50.3%), 159 (27.8%) respectively. alone, 56.4%, 60.5%, 84.1%, respectively ( P trend =0.001). These 48.7% 73.4% among moderate only BNP/NT-proBNP≥median =0.003). reduced death/HFH compared alone regardless severity interaction =0.50). CONCLUSIONS: In regurgitation enrolled trial, increased an BNP/NT-proBNP≥median, more so if had occurred. Treatment all-cause mortality consistently HF. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01626079.