title: Influence of non-cardiac comorbidities on outcome after percutaneous mitral valve repair: results from the German transcatheter mitral valve interventions (TRAMI) registry.
abstract: OBJECTIVE
  To investigate the influence of non-cardiac comorbidities on outcomes of patients enrolled in the German transcatheter mitral valve interventions (TRAMI) registry.
  
  
  RESULTS
  Intrahospital and 30-day MACCE rates (death of all causes, stroke and myocardial infarction) of 828 patients from the TRAMI registry were stratified by the number of non-cardiac comorbidities. The following non-cardiac comorbidities were prospectively recorded in the registry: diabetes, renal insufficiency, extracardiac arteriopathy, chronic lung disease, neurological disease or malignancy on palliative care. The 375 (45.3 %) patients with multiple (≥2) non-cardiac comorbidities presented with higher NYHA classes, higher logistic Euroscores, higher levels of NT-proBNP and a shorter 6-min walk distance. Rates of intraprocedural death (0.3 vs. 0.0 %, p = 0.41) and intrahospital MACCE (3.6 vs. 1.9 %, p = 0.16) were not significantly higher in patients with multiple non-cardiac comorbidities, but 30-day MACCE rate was significantly enhanced (6.4 vs. 3.6 %, p = 0.049). However, both patient groups showed a similar clinical improvement after 30 days. Renal insufficiency was the only non-cardiac comorbidity which was independently associated with the 30-day MACCE rate.
  
  
  CONCLUSIONS
  MitraClip device placement is feasible and safe in patients with multiple non-cardiac comorbidities resulting in a significant clinical improvement and acceptable intrahospital and 30-day event rates. Renal failure is an independent predictor of outcome.
authors.affiliation: Deutsches Herzkompetenz Zentrum, Abteilung Kardiologie, Universitätsklinikum Tübingen, Medizinische Klinik III, Otfried-Müller-Str. 10, 72076, Tübingen, Germany. christine.zuern@gmx.de.
authors.forename: Christine S
authors.initials: CS
authors.lastname: Zuern
authors.affiliation: Deutsches Herzkompetenz Zentrum, Abteilung Kardiologie, Universitätsklinikum Tübingen, Medizinische Klinik III, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Bauer
authors.affiliation: Universitäres Herzzentrum Eppendorf, Hamburg, Germany.
authors.forename: Edith
authors.initials: E
authors.lastname: Lubos
authors.affiliation: Klinikum Siegburg (Kardiologie und Angiologie), Siegburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Boekstegers
authors.affiliation: Herzzentrum, Georg-August-Universität Göttingen, Göttingen, Germany.
authors.forename: Miriam
authors.initials: M
authors.lastname: Puls
authors.affiliation: Universitätsmedizin Mainz, 2. Med. Klinik, Mainz, Germany.
authors.forename: Ralph Stephan V
authors.initials: RS
authors.lastname: Bardeleben
authors.affiliation: Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany.
authors.forename: Taoufik
authors.initials: T
authors.lastname: Ouarrak
authors.affiliation: Herzzentrum Brandenburg, Bernau, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Butter
authors.affiliation: Cardioangiologisches Centrum Bethanien, CCB, Frankfurt Am Main, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Eggebrecht
authors.affiliation: Universitätsklinikum Bonn (Med. Klinik und Poliklinik II), Bonn, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Nickenig
authors.affiliation: Herzzentrum, Ludwigshafen, Germany.
authors.forename: Ralph
authors.initials: R
authors.lastname: Zahn
authors.affiliation: Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.affiliation: Deutsches Herzkompetenz Zentrum, Abteilung Kardiologie, Universitätsklinikum Tübingen, Medizinische Klinik III, Otfried-Müller-Str. 10, 72076, Tübingen, Germany. Andreas.May@klinikum-memmingen.de.
authors.forename: Andreas E
authors.initials: AE
authors.lastname: May
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000379:methods*; D005260:Female; D005858:Germany / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000473:pathology*; D008944:Mitral Valve Insufficiency / Q000628:therapy*; D009203:Myocardial Infarction / Q000453:epidemiology / Q000401:mortality; D011446:Prospective Studies; D012042:Registries; D051437:Renal Insufficiency / Q000150:complications* / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
keywords: Heart failure; MitraClip; Mitral valve regurgitation; Non-cardiac comorbidities; Percutaneous mitral valve repair