The following is a summary of “External Validation of COAPT Risk Score in Patients Undergoing Transcatheter Edge-To-Edge Repair of Severe, Functional Mitral Regurgitation: a Multicenter, Observational Italian-Polish Study,” published in the November 2024 issue of Cardiology by Gąsecka et al.    

The COAPT Risk Score was developed to predict all-cause mortality and heart failure hospitalization (HFH) in individuals with severe, functional mitral regurgitation (FMR) undergoing transcatheter edge-to-edge repair (TEER) using the MitraClip device.  

Researchers conducted a retrospective study to validate the COAPT Risk Score in individuals undergoing TEER for severe FMR.  

They included 344 individuals with 218 COAPT eligible and 126 COAPT non-eligible who underwent MitraClip implantation (March 2012 and July 2023). The primary endpoint was a composite of all-cause mortality and HFH at 2 years. The COAPT Risk Score was calculated for everyone, and performance was assessed using the area under curve (AUC). 

The results showed that the COAPT Risk Score had poor predictive value for the primary endpoint across all groups (AUC ≤0.61) and performed better among individuals with lower baseline risk (COAPT Score <4 points, AUC 0.658) compared to those with higher risk (COAPT Score ≥4 points, AUC 0.523). A higher COAPT Score was linked with a high risk of the primary endpoint in the overall population (P<0.001), COAPT-eligible group (P=0.020), and COAPT non-eligible group (P=0.042). For individuals with a COAPT Score <4, the risk of the primary endpoint was significantly higher (aHR 1.338, 95% CI 1.031-1.737, P=0.028), but not in those with higher scores.  

They concluded that the COAPT Risk Score has limited predictive value in individuals with severe FMR, with better performance in those at lower risk.  

Source: ajconline.org/article/S0002-9149(24)00820-8/abstract