Application of the COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy) score in patients with severe functional mitral regurgitation and percutaneous management with the MitraClip device

Introduction: Functional mitral regurgitation is defined as blood backflow from the left ventricle to the left atrium during ventricular systole.In the short-term, this causes heart failure due to geometric alteration, leading to poor papillary muscle and chordae tendineae function as a result of blood flow compensation.Percutaneous treatment with MitraClip (Abbott Vascular) has shown improved mortality, morbidity and quality of life in patients with severe functional mitral regurgitation.Objective: To describe COAPT scores in patients with functional mitral regurgitation after being treated with the MitraClip device at a cardiovascular institution between July 2016 and May 2024.Methods: An observational descriptive study was performed with the application of a risk index score.Results: Fifty-nine patients met the inclusion criteria for the study.The mean age was 71 ± 8.3 years, 83% had hypertension, 74.5% had hypercholesterolemia, 57.6% had coronary heart disease and 23% had previous myocardial revascularization.There were 25 heart failure hospitalizations (42.3% of the population), and 4 deaths (6.77%).A left ventricular ejection fraction (LVEF) less than 25% (OR: 7.38; 95% CI: 1.83-28.9),left ventricular end-systolic diameter greater than 5.5 cm (OR: 3.56; 95% CI: 1.1-10.9),and left ventricular end-diastolic diameter greater than 7.5 cm (OR: 25.3; 95% CI: 1.2-509) were significant predictors of hospitalization for heart failure, but not of mortality.Conclusions: The COAPT score did not significantly predict mortality results in the study population, although left ventricular diameter measurements (both systolic and diastolic) as well as LVEF less than 25% were predictors of hospitalization for heart failure over two years of follow up.