Log in to MyACC
Transcatheter Mitral Valve Repair and Hospitalization Rates
Quick Takes
- This population-based cohort study of patients who underwent TMVr, reports significant and sustained reductions in all-cause and HF hospitalizations within 1 year after the procedure compared with the year prior to the intervention.
- These results seem noteworthy given the challenges in modifying readmission patterns, especially in the HF population.
- Additional prospective studies are indicated to validate these results given limitations of the current study design, and to assess which patients are most likely to benefit from reduced hospitalization after TMVr.
Study Questions:
What is the effect of transcatheter mitral valve repair (TMVr) on hospitalization rates by assessing pre- and postprocedural hospitalization patterns?
Methods:
The investigators included all patients who underwent TMVr in Ontario, Canada, between 2011 and 2017 in this observational study using population-based data. Hospitalization person-year rates were assessed in the years before and after TMVr and four predefined intervals: 1-30, 31-90, 91-182, and 183-365 days. Main outcomes of interest were all-cause and heart failure (HF) hospitalizations. Poisson regression models were used to compare incidence rates across all time periods. Generalized estimating equation methods were used to account for multiple observation periods per subject per model (pre- and postprocedural periods).
Results:
The study cohort included 523 patients. In the year preceding TMVr, 66.2% of patients were hospitalized compared with 47.4% in the year following. There were stepwise increases in both all-cause and HF hospitalization rates in the periods preceding the index procedure, and all postprocedural periods had significantly lower hospitalization rates. The adjusted rate ratios for all-cause and HF-related hospitalization in the year after TMVr were 0.65 (95% confidence interval [CI], 0.56-0.76) and 0.38 (95% CI, 0.29-0.51), respectively. All time periods had significant reductions in all-cause and HF hospitalization in the adjusted analysis.
Conclusions:
The authors concluded that in this population-based study, significant reductions were observed in both all-cause and HF-related hospitalizations in all time periods after TMVr compared with the year prior.
Perspective:
This observational study of patients who underwent TMVr, reports significant and sustained reductions in all-cause and HF hospitalizations within 1 year after the procedure compared with the year prior to the intervention. These results seem noteworthy given the challenges in modifying readmission patterns, especially in the HF population. Additional prospective studies are indicated to validate these results given limitations of the study design, and to assess which patients are most likely to benefit from reduced hospitalization after TMVr.
Clinical Topics: Cardiac Surgery, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Prevention, Valvular Heart Disease, Cardiac Surgery and Arrhythmias, Cardiac Surgery and Heart Failure, Cardiac Surgery and VHD, Acute Heart Failure, Interventions and Structural Heart Disease, Mitral Regurgitation
Keywords: Cardiology Interventions, Heart Failure, Heart Valve Diseases, Heart Valve Prosthesis, Hospitalization, Mitral Valve Insufficiency, Patient Admission, Patient Readmission, Secondary Prevention, Transcatheter Aortic Valve Replacement
< Back to Listings
