SPC365

Simple, Yet Powerful: The MitraScore as a Predictor of Mortality After Mitral Transcatheter Edge-to-Edge Repair

Session: Sessão de Posters 41 - Intervenções estruturais cardíacas e resultados
Speaker: Fábio Viveiros

Congress: CPC 2026
Topic: H. Interventional Cardiology and Cardiovascular Surgery
Theme: 25. Interventional Cardiology
Subtheme: 25.3 Non-coronary Cardiac Intervention
Session Type: Posters Eletrónicos
FP Number: ---
Authors: Fabio Viveiros; Daniel Inácio Cazeiro; Cláudia Jorge; João Silva Marques; Pedro Cardoso; Miguel Nobre Menezes; Fausto J. Pinto

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos"><span style="color:#000000"><strong>Introduction:</strong></span></span></span><br />
<span style="font-size:12pt"><span style="font-family:Aptos"><span style="color:#000000">The MitraScore is a recently developed risk stratification tool designed to predict mortality after mitral transcatheter edge-to-edge repair (M-TEER). It integrates eight easily obtainable clinical parameters into a single score, allowing for rapid bedside assessment. However, its external validation in real-world populations remains limited.&nbsp;</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos"><span style="color:#000000"><strong>Aim: </strong></span></span></span><br />
<span style="font-size:12pt"><span style="font-family:Aptos"><span style="color:#000000">To evaluate the prognostic performance of the MitraScore in predicting all-cause mortality among patients undergoing M-TEER at our centre.</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos"><span style="color:#000000"><strong>Methods:</strong></span></span></span><br />
<span style="font-size:12pt"><span style="font-family:Aptos"><span style="color:#000000">We conducted a retrospective single-centre study including all consecutive patients who underwent M-TEER between 2013 and October 2025. Clinical and laboratory data were obtained from electronic medical records. The MitraScore was calculated by assigning one point for each of the following: age &ge;75 years, anemia, eGFR &lt;60 mL/min/1.73 m&sup2;, left ventricular ejection fraction (LVEF) &lt;40%, peripheral artery disease, chronic obstructive pulmonary disease, high-dose diuretics, and absence of renin&ndash;angiotensin system inhibitor therapy. Survival was analysed using Kaplan&ndash;Meier curves and Cox regression. Diagnostic accuracy of the MitraScore for all-cause mortality was assessed using ROC analysis.</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos"><span style="color:#000000"><strong>Results:</strong></span></span></span><br />
<span style="font-size:12pt"><span style="font-family:Aptos"><span style="color:#000000">A total of 95 procedures were performed, with 86 patients included in the final analysis (mean age 74 &plusmn; 11 years, 63% male). Underlying heart disease was primary mitral regurgitation in 43%, ischemic cardiomyopathy in 29%, non-ischemic dilated cardiomyopathy in 27%, and hypertrophic cardiomyopathy in 1%. Mean LVEF was 44 &plusmn; 15%, hemoglobin 12.6 &plusmn; 1.8 g/dL, and eGFR 50 &plusmn; 22 mL/min/1.73 m&sup2;. Peripheral artery disease and COPD were present in 11% and 15% of patients, respectively.</span></span></span><br />
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<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos"><span style="color:#000000">Over a median follow-up of 42 months, all-cause mortality was 22%, 35%, and 59% at 12, 24, and 60 months, respectively. Mean MitraScore was 3 &plusmn; 1. The score demonstrated good discriminatory performance (AUC = 0.686), with each 1-point increase associated with a 50% higher risk of mortality (HR 1.50; 95% CI 1.21&ndash;1.86; </span></span></span><span style="font-size:12pt"><span style="font-family:Aptos"><span style="color:#000000"><em>p</em></span></span></span><span style="font-size:12pt"><span style="font-family:Aptos"><span style="color:#000000"> &lt; 0.001). The optimal cut-off for mortality prediction was &ge;3 (70% sensitivity, 68% specificity).</span></span></span></p>

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<span style="font-size:12pt"><span style="font-family:Aptos"><span style="color:#000000"><strong>Conclusion:</strong></span></span></span><br />
<span style="font-size:12pt"><span style="font-family:Aptos"><span style="color:#000000">The MitraScore showed good performance in predicting all-cause mortality after M-TEER in our real-world cohort, confirming its validity as a simple and practical risk stratification tool in this population.</span></span></span></p>