Why Did COAPT Win While MITRA-FR Failed? Defining the Appropriate Patient Population for MitraClip

Kimberly Atianzar; Ming Zhang; Zachary Newhart; Sameer Gafoor

doi:10.15420/icr.2018.40.1

Why Did COAPT Win While MITRA-FR Failed? Defining the Appropriate Patient Population for MitraClip

Interv Cardiol. 2019 Feb;14(1):45-47. doi: 10.15420/icr.2018.40.1.

Authors

Kimberly Atianzar^{1

2}, Ming Zhang², Zachary Newhart², Sameer Gafoor^{2

3}

Affiliations

¹ Medical College of Georgia at Augusta University Augusta, GA, US.
² Swedish Heart and Vascular Institute Seattle, WA, US.
³ CardioVascular Center Frankfurt Frankfurt, Germany.

Abstract

In 2018, the world of functional mitral regurgitation changed with the presentation of two trials - Multicentre Study of Percutaneous Mitral Valve Repair MitraClip Device in Patients With Severe Secondary Mitral Regurgitation (MITRA-FR) and Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT). The trials, which seemed to point in two different directions, raised significant questions for the field. This article looks at the differences in effective regurgitant area, guideline-directed medical therapy, patient selection, technical clues and other reasons why the trials had similar aims but very different findings.

Keywords: COAPT; MITRA-FR; Mitral regurgitation; congestive heart failure; effective orifice area; functional mitral regurgitation; heart failure; optimal medical therapy; secondary mitral regurgitation.

Publication types

Review