ArticleJournal of the Society for Cardiovascular Angiography & Interventions2026
Impact of Race and Ethnicity on Outcomes After Mitral Transcatheter Edge-to-Edge Repair: Analysis From the COAPT Trial.
Article in Journal of the Society for Cardiovascular Angiography & Interventions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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13 authors.
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Abstract
Background: Few studies have evaluated race and ethnicity-based differences in outcomes in patients with heart failure and secondary mitral regurgitation (SMR). We examine the impact of race and ethnicity on outcomes after treatment of severe SMR with mitral transcatheter edge-to-edge repair (M-TEER) with the MitraClip device plus guideline-directed medical therapy (GDMT) compared with GDMT alone in the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT) trial. Methods: Patients in the COAPT trial were stratified by self-identified race and ethnicity as White, Black, or Hispanic. Outcomes assessed included echocardiographic core laboratory-assessed mitral regurgitation (MR) reduction, the composite outcome of all-cause mortality or heart failure hospitalization (HFH), and change in quality of life as measured by the Kansas City Cardiomyopathy Questionnaire (KCCQ) during 2-year follow-up. Results: Of 585 patients, 457 (78.1%) identified as White, 88 (15.0%) identified as Black, and 40 (6.8%) identified as Hispanic. At 2 years, MR reduction was present with M-TEER in White and Black patients, and KCCQ improvement was observed in White and Hispanic patients. The 2-year rate of mortality or HFH with M-TEER compared with GDMT alone was lower in White patients (hazard ratio [HR], 0.59; 95% CI, 0.46-0.75) and Black patients (HR, 0.30; 95% CI, 0.14-0.61), but not Hispanic patients (HR, 1.09; 95% CI, 0.46-2.57; Conclusions: In the COAPT trial, MitraClip treatment reduced MR in White and Black patients and improved quality of life in White and Hispanic groups. Freedom from all-cause mortality or HFH through 2-year follow-up improved with M-TEER compared with GDMT alone in White patients and possibly to an even greater extent in Black patients. The small number of Hispanic patients enrolled precludes definitive conclusions in that group.
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