Abstract 85: Evaluation Of Guideline-Directed Medical Therapy Prescribing In Patients Undergoing Transcatheter Edge-to-Edge Repair

Background: The benefits of guideline-directed medical therapy (GDMT) in heart failure (HF) are well established, but the optimization of GDMT prior to and following transcatheter edge-to-edge repair (TEER) remains understudied. The purpose of this study was to evaluate GDMT use pre-and post-TEER. Methods: We performed a retrospective analysis of the electronic health records from 2019 to 2021 at the University of Illinois at Chicago of patients that underwent TEER. Patients were included if they had follow-up records within 6 months and a baseline ejection fraction (EF) < 50%. Demographic information, vitals, labs, and pertinent echocardiogram information were obtained at baseline and 6 months. GDMT doses were collected at baseline, discharge, 30 days, 3, and 6 months. Results: In total, 20 patients were included: 15 were male (75%) and 19 were non-white (95%). The average age was 66.8 years old (range 32.8-86.5). Past medical history was significant for 19 with hypertension (95%) and 15 with hyperlipidemia, coronary artery disease, and smoking history, respectively (75%). Pre-procedure mean blood pressure and heart rate were 123/74 mmHg and 81 bpm. Average creatinine was 1.66 ± 0.94 mg/dL and 1.10 ± 0.97 mg/dL at baseline and 6 months, respectively. A total of 9 patients (45%) had functional mitral regurgitation, 11 (65%) had primary or degenerative mitral regurgitation. A total of 6 patients (30%) had 11 readmissions for acute decompensated HF, 2 patients died, and 1 patient’s EF improved to > 50% by 6 months. GDMT is described in Table 1. No patients were prescribed SGLT2 inhibitors. Conclusion: GDMT for patients pre-and post-TEER procedure is neither prescribed nor titrated effectively. Further investigation will focus on confounding factors affecting prescribing patterns and titrations. Our findings demonstrate a continued opportunity for quality improvement in GDMT optimization during TEER hospital admission and follow-up visits.