email article Patients with secondary mitral regurgitation (MR) who were left with high gradients after a MitraClip procedure were not inherently at a disadvantage in their subsequent clinical outcomes, according to a COAPT analysis. MitraClip-treated trial participants, divided into quartiles by mitral valve gradient (MVG) on discharge, shared similar odds of combined all-cause mortality and heart failure hospitalization at 2 years ( P=0.78): Q2 (3.0 mm Hg; n=61): 49.2% Q3 (4.2 mm Hg; n=62): 40.6% Q4 (7.2 mm Hg; n=64): 40.9% These findings persisted after adjustment for baseline clinical and echocardiographic characteristics, post-procedure MR grade, and number of clips implanted, reported Howard Herrmann, MD, of the Hospital of the University of Pennsylvania in Philadelphia, and colleagues in