Influence of age, frailty and non-cardiac comorbidities on survival in patients undergoing mitral valve edge-to-edge repair - a perspective from the German health care system.

Authors

Kerstin Piayda, Nabor Keweloh, Bernhard Unsöld, Samuel Sossalla, Amin Polzin, Fabian Voss, Jafer Haschemi, Marcel Giemsa, Ursula Marschall, Beata Hennig, Michael Beil, Malte Kelm, Christian Jung

Published in

International journal of cardiology. Heart & vasculature. Volume 66. Pages 101990. Epub Aug 12, 2026.

Abstract

The influence of age, frailty, and non-cardiac comorbidities on long-term survival in a large, real-world cohort of patients undergoing mitral valve edge-to-edge-repair (M-TEER) was investigated. In addition, associated healthcare resource utilization and expenditure were evaluated.
Demographic data, data on frailty and co-morbidities were drawn from the anonymized database of the second largest sickness fund in Germany and analysed in regards of long-term survival.
Relevant data was available in 4896 patients. Very old patients (80-99 years) had an impaired survival as compared to younger ones (OR 1.2, 95% CI [1.07;1.49], p = 0.005). With increasing level of frailty (care level 1: OR 1.43, 95% CI [1.19;1.72], p = 0.0001; care level 2: OR 1.63, 95% CI [1.45;1.84], p < 0.0001; care level 3-5: OR 2.09, 95% CI [1.79;2.45], p < 0.0001), and increasing number of non-cardiac comorbidities (one: OR 1.55, 95% CI [1.32, 1.82], p < 0.001; two: OR 2.21, 95% CI [1.90;2.59], p < 0.001, three or more: OR 2.82, 95% CI [2.37;3.36], p < 0.001) survival was significantly impaired. Female sex seems to be protective (OR 0.75, 95% CI [0.68;0.82], p < 0.001), whereas right heart failure at baseline (OR 1.83, 95% CI [1.65;2.03], p < 0.001) has a negative effect on survival. Overall medical expenses 12-months before the procedure were equal to 12-months after M-TEER (12-months before: 5796€ IQR [856.5;14,856.0] vs. 12-months after: 4.184€ IQR [370;15,316].
Age, frailty and comorbidities play a significant role in survival prediction of patients undergoing M-TEER. Overall medical expanses did not change after M-TEER however heart failure hospitalizations were less frequent.

PMID:
42633073
Bibliographic data and abstract were imported from PubMed on 23 Aug 2026.

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