Evidence map›Paper›PMID 40778453›Full record

Observational studyEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2025

Prognostic significance of mitral annular calcification assessed by computed tomography for transcatheter edge-to-edge repair outcomes.

Takashi Nagasaka, Vivek Patel, Kazuki Suruga, Yuchao Guo, Ofir Koren, Alon Shechter, Dhairya Patel, Tracy Salseth, Tarun Chakravarty, Aakriti Gupta and 5 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Takashi NagasakaCedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA.
Vivek PatelCedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA.
Kazuki SurugaCedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA.
Yuchao GuoCedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA.
Ofir KorenCedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA.
Alon ShechterCedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA.
Dhairya PatelCedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA.
Tracy SalsethCedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA.
Tarun ChakravartyCedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA.
Aakriti GuptaCedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA.
Hideki IshiiDepartment of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Gunma, Japan.
Hasan JilaihawiCedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA.
Moody MakarCedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA.
Mamoo NakamuraCedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA.
Raj R MakkarCedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMitral annular calcification (MAC) presents challenges for transcatheter edge-to-edge repair (TEER). Limited data exist on how the anatomical features of MAC, assessed by computed tomography (CT), may be associated with TEER outcomes.

aimsWe sought to examine the association between CT features of MAC and clinical outcomes after TEER at 3 years.

methodsThis retrospective observational study included patients who underwent TEER and preprocedural CT. Patients were classified into no/mild MAC and moderate/severe MAC groups. Classification was determined by scoring calcium thickness, distribution, trigone involvement, and leaflet calcification. The primary outcome was all-cause mortality 3 years after TEER.

resultsAmong 391 patients who underwent pre-TEER cardiac CT, 318 (81.3%) had no/mild MAC, and 73 (18.7%) had moderate/severe MAC. At 3 years, all-cause mortality was comparable between the groups (17.6% vs 24.7 %; p=0.17), whereas patients with no/mild MAC had a significantly better New York Heart Association Class than those with moderate/severe MAC (p=0.029). Calcium thickness >5 mm and leaflet involvement were significant predictors of all-cause mortality at 3 years (odds ratio [OR] 2.38, 95% confidence interval [CI]: 1.08-5.25; p=0.032; OR 6.71, 95% CI: 3.28-13.7; p<0.001); patients exhibiting both of these indicators had a significantly higher incidence of all-cause mortality compared to those with calcium thickness ≤5 mm and no leaflet calcification.

conclusionsOverall, all-cause mortality did not significantly differ between patients with varied MAC severity. However, greater calcium thickness and leaflet involvement were associated with worse clinical outcomes in patients undergoing TEER. Detailed preoperative CT evaluation can facilitate the prediction and management of TEER outcomes.

Indexed as

CalcinosisCardiac CatheterizationHeart Valve Prosthesis ImplantationMitral ValveMitral Valve InsufficiencyTomography, X-Ray ComputedAgedAged, 80 and overFemaleHumansMalePrognosisRetrospective StudiesTreatment Outcome

Identifiers

PMID40778453
PMCPMC12319576

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.