{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:01:40Z","timestamp":1787508100781,"version":"build-2736575974"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,10,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The relative impact of cardiac and noncardiac mortality in patients with secondary mitral regurgitation undergoing mitral transcatheter edge\u2010to\u2010edge repair (M\u2010TEER) has been poorly investigated. We aimed to assess the competing risks and independent predictors of cardiac and noncardiac mortality in a real\u2010world secondary mitral regurgitation population treated with M\u2010TEER and included in the GIOTTO (Italian Society of Interventional Cardiology [GIse] Registry Of Transcatheter Treatment of Mitral Valve Regurgitation) registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Competing risks analysis was used to assess the cumulative incidence of cardiac and noncardiac mortality. Cox regression identified independent predictors of each outcome. Co\u2010primary outcomes were cardiac and noncardiac death at 2\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The analysis included 1185 consecutive patients with secondary mitral regurgitation treated with M\u2010TEER between January 2016 and March 2020 (median age 74\u2009years). Two\u2010year cumulative incidences of cardiac and noncardiac mortality were 19% and 12%, respectively. At multivariable analysis, predictors of cardiac mortality were age (hazard ratio [HR], 1.03;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.002), New York Heart Association class (HR, 1.44;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.018), previous hospitalization for heart failure (HR, 1.67;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.016), hemoglobin (HR, 0.89;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.016), left ventricular end\u2010diastolic diameter (HR, 1.02;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.025), left ventricular ejection fraction (HR, 0.98;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.022), and daily furosemide dose (HR, 1.19;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.003). Predictors of noncardiac mortality were New York Heart Association class (HR, 1.70;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.03), estimated glomerular filtration rate (HR, 0.98;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.002), and smoking habit (HR, 1.82;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with secondary mitral regurgitation treated with M\u2010TEER show a high 2\u2010year incidence of both cardiac and noncardiac mortality. Understanding competing risks of mortality may improve patient selection for M\u2010TEER.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.040496","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T12:09:21Z","timestamp":1760011761000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Competing Risks of Cardiac and Noncardiac Mortality in Patients With Secondary Mitral Regurgitation Undergoing Transcatheter Edge\u2010to\u2010Edge Repair"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0515-639X","authenticated-orcid":false,"given":"Luca","family":"Esposito","sequence":"first","affiliation":[{"name":"University Federico II","place":["Naples, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8665-9890","authenticated-orcid":false,"given":"Marco","family":"Di Maio","sequence":"additional","affiliation":[{"name":"University of Salerno","place":["Salerno, Italy"]},{"name":"University Hospital San Giovanni di Dio e Ruggi d\u2019Aragona","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Baldi","sequence":"additional","affiliation":[{"name":"University Hospital San Giovanni di Dio e Ruggi d\u2019Aragona","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Di Lorenzo","sequence":"additional","affiliation":[{"name":"AORN Ospedali dei Colli, Monaldi Hospital","place":["Naples, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9792-7782","authenticated-orcid":false,"given":"Michele","family":"Bellino","sequence":"additional","affiliation":[{"name":"University of Salerno","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9749-8092","authenticated-orcid":false,"given":"Angelo","family":"Silverio","sequence":"additional","affiliation":[{"name":"University of Salerno","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3855-1815","authenticated-orcid":false,"given":"Marianna","family":"Adamo","sequence":"additional","affiliation":[{"name":"University of Brescia","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5467-8736","authenticated-orcid":false,"given":"Arturo","family":"Giordano","sequence":"additional","affiliation":[{"name":"Pineta Grande Hospital","place":["Caserta, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6369-3006","authenticated-orcid":false,"given":"Francesco","family":"De Felice","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliera S. Camillo Forlanini","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Grasso","sequence":"additional","affiliation":[{"name":"Centro Alte Specialit\u00e0 e Trapianti (CAST), Azienda Ospedaliero\u2010Universitaria Policlinico Vittorio Emanuele, University of Catania","place":["Catania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2451-4626","authenticated-orcid":false,"given":"Antonio","family":"Popolo Rubbio","sequence":"additional","affiliation":[{"name":"IRCCS Policlinico San Donato","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3075-0203","authenticated-orcid":false,"given":"Paolo","family":"Denti","sequence":"additional","affiliation":[{"name":"San Raffaele University Hospital","place":["Milan, 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