Results from the COAPT 5-year follow-up study presented at ACC 2023 showed encouraging data that patients receiving TEER for functional MR with the MitraClip device have durable outcomes with lower mortality and lower rate of hospitalization (all-cause, cardiovascular, and heart failure mortality and hospitalizations) compared to patients treated with guideline-directed medical therapy alone.

As the publication outlined, the treatment effect did decrease over time (after two years) as patients in the control arm began to cross over into the treatment arm (as permitted by the study protocol). It is important to point out, however, that a large proportion (42.7%) of those in the control group had already died at two years, before crossover was permitted.

This study indicates that patients with symptomatic moderate to severe or severe functional mitral regurgitation receive durable benefit with MitraClip as compared to GDMT alone.  

All editors: Allison G. Dupont, MD, FSCAI