No therapy with renin–angiotensin system (RAS) inhibitors
(1 = yes, 0 = no)
MitraScore – Explanation and Clinical Context: The MitraScore is a user-friendly risk-prediction tool developed for patients undergoing percutaneous mitral valve repair (transcatheter edge-to-edge mitral repair, TEER). The derivation cohort comprised 1,119 patients and was validated in 725 patients. The score includes the following variables: age ≥75 years; anemia; estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m²; left ventricular ejection fraction (LVEF) <40 %; peripheral artery disease; chronic obstructive pulmonary disease (COPD); high-dose diuretic therapy (e.g., ≥80 mg furosemide/day or ≥2 diuretic agents excluding antialdosteronic drugs); and absence of renin–angiotensin-system (RAS) inhibitor therapy. Each factor carries one point.
In multivariate analysis, each one-point increment increased the hazard of mortality by approximately 55 % (HR ~1.55; 95 % CI ~1.44-1.67, p < 0.001) in the derivation cohort, and the c-statistic was 0.70 in derivation and 0.66 in validation. Although discrimination is only moderate, the simplicity and clinical availability of variables make MitraScore useful for risk stratification in heart-team discussions before mitral TEER.
Clinical interpretation summary: A higher total score suggests higher baseline mortality risk after mitral TEER, implying the need for heightened vigilance, optimisation of comorbidities, and detailed shared decision-making. It does not replace clinical judgement nor contraindicate procedure automatically.