ESC Congress 2026 Abstract · Oct 26, 2026
MitraScore: a simple, powerful tool to predict mortality after mitral transcatheter edge-to-edge repair
By Inacio Cazeiro D, Cravo J, Ferreira D et al.
Introduction: 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. Aim: To evaluate the prognostic performance of the MitraScore in predicting all-cause mortality among patients undergoing M-TEER at our centre. Methods: 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 ≥75 years, anemia, eGFR <60 mL/min/1.73 m², left ventricular ejection fraction (LVEF) <40%, peripheral artery disease, chronic obstructive pulmonary disease, high-dose diuretics, and absence of renin–angiotensin system inhibitor therapy. Survival was analysed using Kaplan–Meier curves and Cox regression. Diagnostic accuracy of the MitraScore for all-cause mortality was assessed using ROC analysis. Results: A total of 95 procedures were performed, with 86 patients included in the final analysis (mean age 74 ± 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 ± 15%, hemoglobin 12.6 ± 1.8 g/dL, and eGFR 50 ± 22 mL/min/1.73 m². Peripheral artery disease and COPD were present in 11% and 15% of patients, respectively. 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 ± 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 1.21–1.86; p < 0.001). The optimal cut-off for mortality prediction was ≥3 (70% sensitivity, 68% specificity). Conclusion: 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.Figure 1For image description, please refer to the figure legend and surrounding text.