{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:58:19Z","timestamp":1753887499205,"version":"3.41.2"},"reference-count":13,"publisher":"Radcliffe Medical Media Ltd","license":[{"start":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T00:00:00Z","timestamp":1597363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/legalcode"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Treatment of secondary (or functional) mitral regurgitation had traditionally been limited to optimal medical therapy because studies have failed to show a survival benefit with mitral valve surgery for this condition. However, recently the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT) trial demonstrated a significant decrease in heart failure hospitalizations and mortality in patients with severe secondary mitral regurgitation treated with percutaneous edge-to-edge mitral valve repair (TMVr) using the MitraClip device compared with medical therapy. Based o the results of the COAPT trial, the Food and Drug Administration granted approval for MitraClip treatment of patients with severe secondary mitral regurgitation in March 2019. In an attempt to understand the economic impact of treating this patient population with TMVr using the MitraClip device, a formal cost-effectiveness analysis was performed alongside the COAPT trial. This review summarizes the methods and results of the economic substudy of the COAPT trial and discusses the value of the MitraClip device from the perspective of the US healthcare system in the treatment of patients with symptomatic heart failure and secondary mitral regurgitation.<\/jats:p>","DOI":"10.15420\/usc.2020.01","type":"journal-article","created":{"date-parts":[[2020,8,17]],"date-time":"2020-08-17T15:15:39Z","timestamp":1597677339000},"source":"Crossref","is-referenced-by-count":1,"title":["Clinical Trial Perspective: Cost-effectiveness of Transcatheter Mitral Valve Repair Versus Medical Therapy in Patients with Heart Failure and Secondary Mitral Regurgitation. Results From the COAPT Trial"],"prefix":"10.15420","volume":"14","author":[{"given":"Suzanne J","family":"Baron","sequence":"first","affiliation":[{"name":"Lahey Hospital and Medical Center, Burlington, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6096","published-online":{"date-parts":[[2020,8,14]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Feldman T, Foster E, Glower DD, et al. Percutaneous repair or surgery for mitral regurgitation. N Engl J Med 2011;364:1395\u2013406. https:\/\/doi.org\/10.1056\/NEJMoa1009355; PMID:\u00a021463154.","DOI":"10.1056\/NEJMoa1009355"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Stone GW, Lindenfeld J, Abraham WT, et al. Transcatheter mitral-valve repair in patients with heart failure. N Engl J Med 2018;379:2307\u201318. https:\/\/doi.org\/10.1056\/NEJMoa1806640; PMID:\u00a030280640.","DOI":"10.1056\/NEJMoa1806640"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Arnold SV, Chinnakondepalli KM, Spertus JA, et al. Health status after transcatheter mitral-valve repair in heart failure and secondary mitral regurgitation: COAPT trial. J Am Coll Cardiol 2019;73:2123\u201332. https:\/\/doi.org\/10.1016\/j.jacc.2019.02.010; PMID:\u00a030894288.","DOI":"10.1016\/j.jacc.2019.02.010"},{"key":"ref3","unstructured":"Mack MJ. COAPT: three-year outcomes from a randomized trial of the MitraClip in patients with heart failure and severe secondary mitral regurgitation. Presented at TCT 2019, San Francisco, US, 28 September 2019."},{"key":"ref4","unstructured":"Anderson JL, Heidenreich PA, Barnett PG, et al. ACC\/AHA statement on cost\/value methodology in clinical practice guidelines and performance measures: a report of the American College of Cardiology\/American Heart Association Task Force on Performance Measures and Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63:2304\u201322. https:\/\/doi.org\/10.1016\/j.jacc.2014.03.016; PMID:\u00a024681044."},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Baron SJ, Wang K, Arnold SV, et al. Cost-effectiveness of transcatheter mitral valve repair versus medical therapy in patients with heart failure and secondary mitral regurgitation: results from the COAPT trial. Circulation 2019;140:1881\u201391. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.119.043275; PMID:\u00a031564137.","DOI":"10.1161\/circulationaha.119.043275"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Reynolds MR, Magnuson EA, Wang K, et al. Cost-effectiveness of transcatheter aortic valve replacement compared with standard care among inoperable patients with severe aortic stenosis: results from the placement of aortic transcatheter valves (PARTNER) trial (cohort B). Circulation 2012;125:1102\u20139. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.111.054072; PMID:\u00a022308299.","DOI":"10.1161\/circulationaha.111.054072"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Noyes K, Veazie P, Hall WJ, et al. Cost-effectiveness of cardiac resynchronization therapy in the MADIT-CRT trial. J Cardiovasc Electrophysiol 2013;24:66\u201374. https:\/\/doi.org\/10.1111\/j.1540-8167.2012.02413.x; PMID:\u00a022913474.","DOI":"10.1111\/j.1540-8167.2012.02413.x"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Lubitz J, Cai L, Kramarow E, Lentzner H. Health, life expectancy, and health care spending among the elderly. N Engl J Med 2003;349:1048\u201355. https:\/\/doi.org\/10.1056\/NEJMsa020614; PMID:\u00a012968089.","DOI":"10.1056\/nejmsa020614"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Obadia JF, Messika-Zeitoun D, Leurent G, et al. Percutaneous repair or medical treatment for secondary mitral regurgitation. N Engl J Med 2018;379:2297\u2013306. https:\/\/doi.org\/10.1056\/NEJMoa1805374; PMID:\u00a030145927.","DOI":"10.1056\/NEJMoa1805374"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Nishimura RA, Bonow RO. Percutaneous repair of secondary mitral regurgitation \u2013 a tale of two trials. N Engl J Med 2018;379:2374\u20136. https:\/\/doi.org\/10.1056\/NEJMe1812279; PMID:\u00a030575469.","DOI":"10.1056\/nejme1812279"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Grayburn PA, Sannino A, Packer M. Proportionate and disproportionate functional mitral regurgitation: a new conceptual framework that reconciles the results of the MITRA-FR and COAPT trials. JACC Cardiovasc Imaging 2019;12:353\u201362. https:\/\/doi.org\/10.1016\/j.jcmg.2018.11.006; PMID:\u00a030553663.","DOI":"10.1016\/j.jcmg.2018.11.006"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Reynolds M, Galper B, Apruzzese P, et al. Cost effectiveness of the MitraClip compared with mitral valve surgery: 12-month results from the EVEREST II randomized controlled trial. J Am Coll Cardiol 2012;60(17 Suppl):B229. https:\/\/doi.org\/10.1016\/j.jacc.2012.08.831","DOI":"10.1016\/j.jacc.2012.08.831"}],"container-title":["US Cardiology Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.uscjournal.com\/articleindex\/usc.2020.01","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T22:27:09Z","timestamp":1737671229000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.uscjournal.com\/articleindex\/usc.2020.01"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,14]]},"references-count":13,"URL":"https:\/\/doi.org\/10.15420\/usc.2020.01","relation":{},"ISSN":["1758-390X","1758-3896"],"issn-type":[{"type":"electronic","value":"1758-390X"},{"type":"print","value":"1758-3896"}],"subject":[],"published":{"date-parts":[[2020,8,14]]},"article-number":"e08"}}