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Current Cardiology Reports

, 21:150 | Cite as

MitraClip: How Do We Reconcile the Inconsistent Findings of MITRA-FR and COAPT?

  • Rina Mauricio
  • Dharam J. KumbhaniEmail author
New Therapies for Cardiovascular Disease (AA Bavry, Section Editor)
First Online:
  • 57 Downloads
Part of the following topical collections:
  1. Topical Collection on New Therapies for Cardiovascular Disease

Abstract

Purpose of Review

Secondary mitral regurgitation (MR) is a common valvular disorder in patients with left ventricular (LV) dysfunction and is associated with worse morbidity and mortality. New data on percutaneous mitral valve (MV) repair suggest that targeting the valve itself may improve outcomes. Our objective is to review two recent trials (MITRA-FR and COAPT) with regard to percutaneous MV repair. We will dive into their methodology and results and propose potential explanations for their divergent outcomes.

Recent Findings

MITRA-FR and COAPT studied the MitraClip plus guideline-directed medical therapy (GDMT) versus GDMT alone in patients with secondary MR. COAPT found an overwhelming benefit in reduction in HF hospitalization and mortality whereas MITRA-FR found no difference between treatment groups. Patient selection, differences in procedural outcomes, and smaller LV dimensions may explain these diametrically opposed results.

Summary

Secondary MR is a common valvular disorder with complex pathophysiology. There are certain patients who will not benefit from percutaneous MV repair. The results of MITRA-FR and COAPT suggest that percutaneous MV repair may benefit carefully selected individuals with secondary MR on maximum tolerated doses of GDMT.

Keywords

Mitral regurgitation Transcatheter repair COAPT MITRA-FR 
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Notes

Compliance with Ethical Standards

Conflict of Interest

Rina Mauricio and Dharam J. Kumbhani declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of CardiologyUniversity of Texas Southwestern Medical CenterDallasUSA

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