title: Previous malignancy is an independent predictor of follow-up mortality after percutaneous treatment of mitral valve regurgitation by means of MitraClip.
abstract: OBJECTIVE
  To investigate the prognostic burden of previously diagnosed and treated malignancies in candidates for percutaneous mitral valve repair (MVR) with MitraClip.
  
  
  RESULTS
  A total of 165 patients underwent MVR and 19 (11.5%) had been previously treated for malignancy and considered healed with life expectancy over 1 year at time of percutaneous MVR. There was a significant trend for an increased overall risk profile (euroSCORE II 14.0±11.4 vs 10.0±6.7, P=.01) in patients with a previous diagnosis of neoplasia. Moreover, neoplastic patients had lower device success rates (78.9% vs 97.3%; P=.001), longer hospitalization (12.3±10.6 vs 7.5±4.9 days, P=.001), and higher 30-day mortality (10.5% vs 2.7%, P=.09). Kaplan-Meier overall estimated 1-, 2-, 3-, and 4-year survival of the overall cohort was 72%, 61%, 48%, and 44%, respectively. Estimated 1- and 2-year survival were 44.4% and 22.2 % in patients with previous neoplasia and 75.3% and 65% in the remaining patients (P<.0001). Median survival was 312 days in the neoplastic group (CI 95%: 182.6-441.4 days) and 1209 days in the remaining patients (CI 95%: 758.8-1659.2 days) (P<.0001). At Cox regression, the strongest determinant for mortality was an anamnesis for neoplasia (HR 2.4, 95% CI 1.4-4.3, P=.001).
  
  
  CONCLUSIONS
  Previous neoplasm is a significant independent predictor of increased mortality after MVR with MitraClip. This association is even stronger than that of other cardiac and overall comorbidities and should be kept into consideration when referring patients for treatment.
authors.affiliation: Heart Center Rostock, Rostock School of Medicine, University Hospital Rostock, Rostock, Germany.|Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany.
authors.forename: Alper
authors.initials: A
authors.lastname: Öner
authors.affiliation: Heart Center Rostock, Rostock School of Medicine, University Hospital Rostock, Rostock, Germany.|Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Ince
authors.affiliation: Heart Center Rostock, Rostock School of Medicine, University Hospital Rostock, Rostock, Germany.|Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany.
authors.forename: Liliya
authors.initials: L
authors.lastname: Paranskaya
authors.affiliation: Heart Center Rostock, Rostock School of Medicine, University Hospital Rostock, Rostock, Germany.|Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany.
authors.forename: Guido
authors.initials: G
authors.lastname: Schröder
authors.affiliation: Heart Center Rostock, Rostock School of Medicine, University Hospital Rostock, Rostock, Germany.|Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Sherif
authors.affiliation: Heart Center Rostock, Rostock School of Medicine, University Hospital Rostock, Rostock, Germany.|Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany.
authors.forename: Olga
authors.initials: O
authors.lastname: Thiele
authors.affiliation: Heart Center Rostock, Rostock School of Medicine, University Hospital Rostock, Rostock, Germany.|Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany.
authors.forename: Alla
authors.initials: A
authors.lastname: Neuhausen
authors.affiliation: Heart Center Rostock, Rostock School of Medicine, University Hospital Rostock, Rostock, Germany.|Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Kische
authors.affiliation: Heart Center Rostock, Rostock School of Medicine, University Hospital Rostock, Rostock, Germany.|Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Ortak
authors.affiliation: Heart Center Rostock, Rostock School of Medicine, University Hospital Rostock, Rostock, Germany.|Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D Ancona
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D016009:Chi-Square Distribution; D016208:Databases, Factual; D004452:Echocardiography; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D015999:Multivariate Analysis; D009369:Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Mitral Regurgitation; Mitral valve; Neoplasia; Percutaneous intervention