As reported in 2 Minute Medicine, the MITRA-FR trial doesn’t appear to improve outcomes in secondary mitral regurgitation. See summary results below or follow the link to read the entire article for full results.
- Among patients with heart failure with reduced ejection fraction (HFrEF) and severe secondary mitral regurgitation on medical therapy, percutaneous mitral valve repair did not significantly reduce 12-month rates of death or hospitalization due to heart failure when compared to medical therapy alone.
- Percutaneous mitral valve repair was associated with increased rates of stroke, need for renal-replacement therapy, and severe hemorrhage.
Study Rundown: Among patients with HFrEF, secondary mitral regurgitation is associated with poor clinical outcomes; however, it is unknown whether the regurgitation impacts prognosis and if intervention is warranted. The aim of this trial was to determine if percutaneous mitral valve repair improved outcomes when added to medical therapy among patients with HFrEF and severe mitral regurgitation. The primary outcome, death or hospitalization due to heart failure, was not significantly different between interventional and control groups. There was also no significant difference in key secondary outcomes, including the individual components of the primary outcome, death from cardiovascular causes, and survival free from major adverse cardiovascular events (MACEs). Additionally, percutaneous intervention demonstrated a higher incidence of stroke, renal-replacement therapy, and severe hemorrhage. The results of this study conflict with other recent evidence supporting valve repair in this population; thus, more data is required before definitive conclusions are drawn.