Lindenfeld JA, Abraham WT, Grayburn PA, et al. - In the COAPT trial (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation), decrease in heart failure (HF) hospitalizations (HFHs) and all-cause mortality (ACM) was conferred by transcatheter mitral valve repair (TMVr) plus maximally tolerated guideline-directed medical therapy (GDMT) vs GDMT alone in symptomatic patients with HF and secondary mitral regurgitation (SMR), so, researchers herein assessed contributions of the degree of SMR employing the effective regurgitation orifice area, regurgitant volume, and left ventricular end-diastolic volume index to the advantage of TMVr in the COAPT trial. In this post hoc secondary analysis, 548 patients were involved. Experts assessed a subgroup of COAPT patients (group 1) with features consistent with patients enrolled in MITRA-FR (n = 56) (Multicenter Study of Percutaneous Mitral Valve Repair MitraClip Device in Patients With Severe Secondary Mitral Regurgitation) vs the rest of the (group 2) COAPT patients (n = 492). According to findings, ACM or HFH were not improved at 24 months in a small subgroup of COAPT-resembling patients enrolled in MITRA-FR but this subgroup was significantly benefited with respect to patient-centered outcomes (eg, quality of life and 6-minute walk distance). As per findings of further subgroup study with 24-month follow-up, TMVr-conferred benefit was not completely supported by the proportionate-disproportionate hypothesis.