COAPT Score (MitraClip Responder Model): Explanation and Clinical Context The COAPT Score is a simple point-based model derived from the COAPT randomized trial to stratify the 2-year risk of all-cause death and/or heart failure hospitalization in patients with heart failure and significant secondary mitral regurgitation despite guideline-directed medical therapy. It assigns weighted points to clinical and echocardiographic variables (COPD, AF, NYHA III–IVa, renal dysfunction, LVEF, LVESD, RVSP, and TR grade) and subtracts 3 points if MitraClip TEER is performed.
Clinical significance: The score aids risk assessment and shared decision-making. Higher scores identify patients with more advanced disease, greater ventricular remodeling, and worse hemodynamics—yet these patients often derive the largest absolute benefit from TEER. Interpretation should be integrated with anatomical suitability and comorbidity assessment.
Reference:
Shah NN, Madhavan MV, Gray WA, et al. Prediction of death or HF hospitalization in patients with severe functional MR: the COAPT risk score. JACC Cardiovasc Interv. 2022;15:1893–1905. doi:10.1016/j.jcin.2022.06.026