Author + information
- Slayman Nabih Obeid,
- Fabian Nietlispach,
- Adrian Attinger-Toller,
- Hector Rodriguez,
- Maurizio Taramasso and
- Francesco Maisano
Background: The Mitraclip procedure has offered a valuable alternative to medical therapy in patients with severe inoperable mitral regurgitation. There is now evidence of a sustained improvement in quality of life and NYHA functional classification however this improvement could be hindered by concomitant coronary artery disease. We sought to evaluate the value of Syntax Score II in patients with CAD undergoing a Mitraclip procedure.
Methods: The cohort comprised of 75 consecutive patients who underwent a Mitraclip procedure at the university hospital of Zürich. All patients had a history of coronary artery disease with a complete anatomical syntax score and syntax score II at baseline. The primary studied outcome was a combination of all-cause mortality, rehospitalisation for worsening of symptoms or reoperation (re-clipping).
Results: Patients were followed to a median of 271 days and the primary outcome occurred in 33% of the cases (n=25). Baseline risk stratification was studied according to tertiles of Syntax score II [SxSII low ≤ 46.5 (n=25), SxSII Mid 56.6 – 54.4 (n=25) and SxSII High ≥ 54.5 (n=25)]. Patients in the highest Syntax tertile had a lower left ventricular ejection fraction(33% vs 40% vs 53%) with a higher log-BNP(3.6 vs 3.45 vs 3.16) when compared to SxSII Mid and SxSII low respectively. In a multivariate binary logistic regression, patients in the SXSII High group and those with a history of M.I were at a significantly higher risk of experiencing adverse events OR 6.12[95%CI 1.450-25.86 p=0.014] and OR3.574 [95% CI 1-174-10.880, p=0.025], respectively. Furthermore in a combined outcome ROC curve analysis, the SxSII showed good discrimination with an AUC of 0.73, p=0.001.A cutoff of SXSII>46 has been identified to have a sensitivity of 77% and specificity of 60% with approximately 42% of the patients experiencing an event during follow-up.
Conclusions: We here show that using SXSII score in CAD patients undergoing a Mitraclip procedure is feasible and of prognostic significance hence widening its clinical utility in valvular heart disease.
Poster Contributions Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Interventional Cardiology: Structural Heart Disease
Abstract Category: 24. Interventional Cardiology: Mitral and Structural Heart Disease
Presentation Number: 1241-148
- 2017 American College of Cardiology Foundation