Prevalence and Mortality of Moderate or Severe Mitral Regurgitation Among Patients Undergoing Percutaneous Coronary Intervention With or Without Heart Failure: Results From CIN Study With 28,358 Patients

Haozhang Huang; Jin Liu; Kunming Bao; Xiaoyu Huang; Dehua Huang; Haiyan Wei; Nuerbahaer Remutula; Tilakezi Tuersun; Wenguang Lai; Qiang Li; Bo Wang; Yibo He; Heyin Yang; Shiqun Chen; Jiyan Chen; Kaihong Chen; Ning Tan; Xiaoyan Wang; Liling Chen; Yong Liu

doi:10.3389/fcvm.2022.796447

Prevalence and Mortality of Moderate or Severe Mitral Regurgitation Among Patients Undergoing Percutaneous Coronary Intervention With or Without Heart Failure: Results From CIN Study With 28,358 Patients

Front Cardiovasc Med. 2022 Mar 3:9:796447. doi: 10.3389/fcvm.2022.796447. eCollection 2022.

Authors

Haozhang Huang¹, Jin Liu¹, Kunming Bao², Xiaoyu Huang³, Dehua Huang³, Haiyan Wei⁴, Nuerbahaer Remutula⁴, Tilakezi Tuersun⁴, Wenguang Lai^{1

5}, Qiang Li¹, Bo Wang¹, Yibo He¹, Heyin Yang⁴, Shiqun Chen¹, Jiyan Chen^{1

5}, Kaihong Chen², Ning Tan^{1

5}, Xiaoyan Wang^{6

7}, Liling Chen², Yong Liu^{1

5}

Affiliations

¹ Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
² Department of Cardiology, Longyan First Hospital Affiliated With Fujian Medical University, Longyan, China.
³ People's Hospital of Yangjiang, Yangjiang, China.
⁴ Department of Cardiology, First People's Hospital of Kashgar, Kashgar, China.
⁵ Guangdong Provincial People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China.
⁶ The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
⁷ Department of Nuclear Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Abstract

Aim: This study investigated the prevalence and mortality associated with moderate or severe mitral regurgitation (MR) among patients undergoing percutaneous coronary intervention (PCI), with or without heart failure (HF).

Methods: We analyzed patients undergoing PCI without mitral valve surgery from the Cardiorenal ImprovemeNt (CIN) study (ClinicalTrials.gov NCT04407936). Patients without echocardiography to determine MR occurrence or lacking follow-up death data were excluded. Primary endpoints were 1-year and long-term all-cause mortality, with a median follow-up time of 5 years (interquartile range: 3.1-7.6).

Results: Of 28,358 patients undergoing PCI treatment [mean age: 62.7 ± 10.7; women: 6,749 (25.6%)], 3,506 (12.4%) had moderate or severe MR, and there was a higher rate of moderate or severe MR in HF group than non-HF group (28.8 vs. 5.6%, respectively). Regardless of HF conditions, patients with moderate or severe MR were older and had worse cardio-renal function and significantly increased 1-year mortality [adjusted hazard ratio (aHR): 1.82, 95% confidence interval (CI): 1.51-2.2], and long-term mortality [aHR: 1.43, 95% CI: 1.3-1.58]. There was no significant difference between patients with HF and those with non-HF (P for interaction > 0.05).

Conclusion: One-eighth of the patients undergoing PCI had moderate or severe MR. Furthermore, one-third and one-seventeenth experienced moderate or severe MR with worse cardiorenal function in the HF and non-HF groups, and increased consistent mortality risk. Further studies should explore the efficacy of mitral interventional procedures for moderate or severe MR after PCI treatment, regardless of HF.

Keywords: coronary artery disease; heart failure; moderate or severe mitral regurgitation; mortality; percutaneous coronary intervention; prevalence.

Associated data

ClinicalTrials.gov/NCT04407936