RESUMEN
BACKGROUND: Transcatheter mitral valve repair (TMVR) could improve survival in functional mitral regurgitation (FMR), but it is necessary to consider the influence of left ventricular ejection fraction (LVEF). Therefore, we compare the outcomes after TMVR with Mitraclip® between two groups according to LVEF. METHODS: In an observational registry study, we compared the outcomes in patients with FMR who underwent TMVR with and without LVEF <30%. The primary endpoint was the combined one-year all-cause mortality and unplanned hospital readmissions due to HF. The secondary end-points were New York Heart Association (NYHA) functional class and mitral regurgitation (MR) severity. Propensity-score matching was used to create two groups with the same baseline characteristics, except for baseline LVEF. RESULTS: Among 535 FMR eligible patients, 144 patients with LVEF <30% (group 1) and 144 with LVEF >30% (group 2) had similar propensity scores and were included in the analyses. The primary study endpoint was significantlly higher in group 1 (33.3% vs. 9.4%, p = 0.002). There was a maintained improvement in secondary endpoints without significant differences among groups. CONCLUSION: FMR patients with LVEF <30% treated with MitraClip® had higher mortality and readmissions than patients with LVEF ≥30% treated with the same device. However, both groups improved the NYHA functional class and MR severity.
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Asunto(s)
Humanos , Masculino , Femenino , Evaluación de Eficacia-Efectividad de Intervenciones , Stents Liberadores de Fármacos/tendencias , Stents Liberadores de Fármacos , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/terapia , Reestenosis Coronaria/tratamiento farmacológico , Angioplastia/métodos , Angioplastia/tendencias , Inhibidores de Agregación Plaquetaria/uso terapéuticoAsunto(s)
Stents Liberadores de Fármacos , Células Endoteliales/fisiología , Infarto del Miocardio/cirugía , Anciano , Angioplastia , Anticuerpos Monoclonales/administración & dosificación , Antígenos CD34/inmunología , Reestenosis Coronaria/epidemiología , Stents Liberadores de Fármacos/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Inhibidores de Agregación Plaquetaria/uso terapéuticoRESUMEN
The aim of this study was to analyze the presence of 62 kDa proteinase and anti-62 kDa proteinase antibody in clinical samples of symptomatic and asymptomatic infected women. Proteinase was detected in all the swabs vaginal of infected women. Significantly, amounts of antigen (mean optical density (OD) values) were detected in swabs vaginal of symptomatic as compared to asymptomatic women. This protein was not detected in the group of patients with Trichomonas vaginalis-culture-negative results and in the groups of samples infected with other agents. Antibody to 62 kDa was detected in the swabs vaginal the only 66.6% of the symptomatic and 55.5% of the asymptomatic infected women. Antibody to 62 kDa was also detected in 7/30 of the swabs vaginal from uninfected women. No significant difference was observed in mean OD values of vaginal swabs of T. vaginalis-infected symptomatic as compared to asymptomatic women. The presence of proteinase in 100% of T. vaginalis-infected women suggested that 62 kDa proteinase could be a virulence factor.