title: Acute outcomes after MitraClip therapy in highly aged patients: results from the German TRAnscatheter Mitral valve Interventions (TRAMI) Registry.
abstract: OBJECTIVE
  The influence of age on baseline demographics and outcomes of patients selected for MitraClip has not been previously investigated.
  
  
  RESULTS
  Baseline demographics and acute outcomes in 1,064 patients from the German TRAMI registry were stratified by age (525 patients ≥76 years and 539 patients <76 years). In elderly patients, logistic EuroSCORE was higher (25[15-40]% vs. 18[10-31]%, p<0.0001) and the proportion of women was greater (47.2% vs. 29.3%, p<0.0001). Elderly patients were more likely to have preserved left ventricular ejection fraction >50% (40.1% vs. 21.8%, p<0.0001) and degenerative mitral regurgitation (DMR, 35.3% vs. 25.6%, p<0.01). Age was the most frequent reason for non-surgical treatment in the elderly (69.4% vs. 36.1%, p<0.0001). The intrahospital MACCE (death, myocardial infarction, stroke) was low in both groups (3.5% vs. 3.4%, p=0.93) and the proportion of non-severe mitral regurgitation at discharge was similar (95.8% vs. 96.4%, p=0.73). A logistic regression model did not reveal any significant impact of age on acute efficacy and safety of MitraClip therapy. In both groups, the majority of patients were discharged home (81.8% vs. 86.2%, p=0.06).
  
  
  CONCLUSIONS
  Elderly and younger patients have similar benefits from MitraClip therapy. Age was the most frequent cause for denying surgery in elderly patients.
authors.affiliation: Herzzentrum Göttingen, Abt. Kardiologie und Pneumologie, Universitätsmedizin Göttingen, Göttingen, Germany. schiwolf@med.uni-goettingen.de
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schillinger
authors.forename: Mark
authors.initials: M
authors.lastname: Hünlich
authors.forename: Stephan
authors.initials: S
authors.lastname: Baldus
authors.forename: Taoufik
authors.initials: T
authors.lastname: Ouarrak
authors.forename: Peter
authors.initials: P
authors.lastname: Boekstegers
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hink
authors.forename: Christian
authors.initials: C
authors.lastname: Butter
authors.forename: Raffi
authors.initials: R
authors.lastname: Bekeredjian
authors.forename: Björn
authors.initials: B
authors.lastname: Plicht
authors.forename: Horst
authors.initials: H
authors.lastname: Sievert
authors.forename: Joachim
authors.initials: J
authors.lastname: Schofer
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.forename: Thomas
authors.initials: T
authors.lastname: Meinertz
authors.forename: Gerd
authors.initials: G
authors.lastname: Hasenfuß
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D003661:Decision Support Techniques; D004867:Equipment Design; D005260:Female; D005858:Germany; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D016017:Odds Ratio; D018579:Patient Selection; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality; D013525:Surgical Instruments; D013997:Time Factors; D016896:Treatment Outcome