Document Type
Article
Publication Date
2019
College/Unit
School of Medicine
Department/Program/Center
Medicine
Abstract
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
Digital Commons Citation
Lodhi, Muhammad U.; Usman, Muhammad S.; Siddiqi, Tariq J.; Khan, Muhammad S.; Kahn, Muhammad A A; Khan, Safi U.; Syed, Intekhab A.; Rahim, Mustafa; Naidu, Srihari S.; Doukky, Rami; and Alkhouli, Mohamad, "Percutaneous Mitral Valve Repair versus Optimal Medical Therapy in Patients with Functional Mitral Regurgitation: A Systematic Review and Meta-Analysis" (2019). Faculty & Staff Scholarship. 2451.
https://researchrepository.wvu.edu/faculty_publications/2451
Source Citation
Lodhi, M. U., Usman, M. S., Siddiqi, T. J., Khan, M. S., Khan, M. A. A., Khan, S. U., Syed, I. A., Rahim, M., Naidu, S. S., Doukky, R., & Alkhouli, M. (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, 2019, 1–10. https://doi.org/10.1155/2019/2753146
Comments
Copyright © 2019 Muhammad Uzair Lodhi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.