Percutaneous Mitral Valve Repair versus Optimal Medical Therapy in Patients with Functional Mitral Regurgitation: A Systematic Review and Meta-Analysis
Joint Authors
Alkhouli, Mohamad
Khan, Muhammad Shahzeb
Lodhi, Muhammad Uzair
Usman, Muhammad Shariq
Siddiqi, Tariq Jamal
Khan, Muhammad Arbaz Arshad
Khan, Safi U.
Syed, Intekhab Askari
Rahim, Mustafa
Naidu, Srihari S.
Doukky, Rami
Source
Journal of Interventional Cardiology
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-10, 10 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-04-21
Country of Publication
Egypt
No. of Pages
10
Main Subjects
Abstract EN
Objectives.
To compare percutaneous mitral valve repair (PMVR) with optimal medical therapy (OMT) in patients with heart failure (HF) and severe functional mitral regurgitation (FMR).
Background.
Many patients with HF and FMR are not suitable for surgical valve replacement and remain symptomatic despite maximal OMT.
PMVR has recently emerged as an alternative solution.
Methods.
We performed a systematic review and a meta-analysis to address this question.
Cochrane CENTRAL, MEDLINE, and Scopus were searched for randomized (RCT) and nonrandomized studies comparing PMVR with OMT in patients with HF and FMR.
Primary endpoint was all-cause midterm mortality (at 1 and 2 years).
Secondary endpoints were 30-day mortality and cardiovascular mortality and HF hospitalizations, at maximum follow-up.
Studies including mixed cohort of degenerative and functional MR were allowed initially but were excluded in a secondary sensitivity analysis for each of the study’s end points.
This meta-analysis was performed following the publication of two RCTs (MITRA-FR and COAPT).
Results.
Eight studies (six observational, two RCTs) comprising 3,009 patients were included in the meta-analysis.
In comparison with OMT, PMVR significantly reduced 1-year mortality (RR: 0.70 [0.56, 0.87]; p=0.002; I2=47.6%), 2-year mortality (RR: 0.63 [0.55, 0.73]; p<0.001; I2=0%), and cardiovascular mortality (RR: 0.32 [0.23, 0.44]; p<0.001; I2=0%).
No significant difference between PMVR+OMT and OMT was noted in HF hospitalization (HR: 0.69 [0.40, 1.20]; p=0.19; I2=85%) and 30-day mortality (RR: 1.13 [0.68, 1.87]; p=0.16; I2=0%).
Conclusions.
In comparison with OMT, PMVR significantly reduces 1-year mortality, 2-year mortality, and cardiovascular mortality in patients with HF and severe MR.
American Psychological Association (APA)
Lodhi, Muhammad Uzair& Usman, Muhammad Shariq& Siddiqi, Tariq Jamal& Khan, Muhammad Shahzeb& Khan, Muhammad Arbaz Arshad& Khan, Safi U.…[et al.]. 2019. Percutaneous Mitral Valve Repair versus Optimal Medical Therapy in Patients with Functional Mitral Regurgitation: A Systematic Review and Meta-Analysis. Journal of Interventional Cardiology،Vol. 2019, no. 2019, pp.1-10.
https://search.emarefa.net/detail/BIM-1181206
Modern Language Association (MLA)
Lodhi, Muhammad Uzair…[et al.]. Percutaneous Mitral Valve Repair versus Optimal Medical Therapy in Patients with Functional Mitral Regurgitation: A Systematic Review and Meta-Analysis. Journal of Interventional Cardiology No. 2019 (2019), pp.1-10.
https://search.emarefa.net/detail/BIM-1181206
American Medical Association (AMA)
Lodhi, Muhammad Uzair& Usman, Muhammad Shariq& Siddiqi, Tariq Jamal& Khan, Muhammad Shahzeb& Khan, Muhammad Arbaz Arshad& Khan, Safi U.…[et al.]. Percutaneous Mitral Valve Repair versus Optimal Medical Therapy in Patients with Functional Mitral Regurgitation: A Systematic Review and Meta-Analysis. Journal of Interventional Cardiology. 2019. Vol. 2019, no. 2019, pp.1-10.
https://search.emarefa.net/detail/BIM-1181206
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1181206