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This article discusses the relationship between low serum albumin levels and outcomes in patients with heart failure (HF) and secondary mitral regurgitation (SMR). The COAPT trial evaluated the safety and effectiveness of transcatheter edge‐to‐edge repair (TEER) with the MitraClip plus guideline‐directed medical therapy (GDMT) versus GDMT alone in these patients. Among 614 patients enrolled in COAPT, 559 had available baseline serum albumin levels. Patients with albumin <4.0 g/dL had higher 4‐year rates of all‐cause death, but there were no significant differences in heart failure hospitalizations or all‐cause hospitalizations according to baseline serum albumin level. The relative effectiveness of TEER plus GDMT versus GDMT alone was consistent in patients with low and high albumin levels.
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