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Prediction of Mortality and Heart Failure Hospitalization After Transcatheter Tricuspid Valve Interventions: Validation of TRISCORE.

JACC. Cardiovascular interventions

Authors: Marianna Adamo, Giulio Russo, Matteo Pagnesi, Edoardo Pancaldi, Hannes Alessandrini, Martin Andreas, Luigi P Badano, Daniel Braun, Kim A Connelly, Paolo Denti, Rodrigo Estevez-Loureiro, Neil Fam, Mara Gavazzoni, Rebecca T Hahn, Claudia Harr, Joerg Hausleiter, Dominique Himbert, Daniel Kalbacher, Edwin Ho, Azeem Latib, Edith Lubos, Sebastian Ludwig, Laura Lupi, Philipp Lurz, Vanessa Monivas, Georg Nickenig, Daniela Pedicino, Giovanni Pedrazzini, Alberto Pozzoli, Denise Pires Marafon, Roberta Pastorino, Fabien Praz, Joseph Rodes-Cabau, Christian Besler, Anne Rebecca Schöber, Joachim Schofer, Andrea Scotti, Kerstin Piayda, Horst Sievert, Gilbert H L Tang, Alessandro Sticchi, David Messika-Zeitoun, Holger Thiele, Florian Schlotter, Ralph Stephan von Bardeleben, John Webb, Julien Dreyfus, Stephan Windecker, Martin Leon, Francesco Maisano, Marco Metra, Maurizio Taramasso

BACKGROUND: Data on the prognostic role of the TRI-SCORE in patients undergoing transcatheter tricuspid valve intervention (TTVI) are limited.

OBJECTIVES: The aim of this study was to evaluate the performance of the TRI-SCORE in predicting outcomes of patients undergoing TTVI.

METHODS: TriValve (Transcatheter Tricuspid Valve Therapies) is a large multicenter multinational registry including patients undergoing TTVI. The TRI-SCORE is a risk model recently proposed to predict in-hospital mortality after tricuspid valve surgery. The TriValve population was stratified based on the TRI-SCORE tertiles. The outcomes of interest were all-cause death and all-cause death or heart failure hospitalization. Procedural complications and changes in NYHA functional class were also reported.

RESULTS: Among the 634 patients included, 223 patients (35.2%) had a TRI-SCORE between 0 and 5, 221 (34.8%) had 6 or 7, and 190 (30%) had ≥8 points. Postprocedural blood transfusion, acute kidney injury, new atrial fibrillation, and in-hospital mortality were more frequent in the highest TRI-SCORE tertile. Postprocedure length of stay increased with a TRI-SCORE increase. A TRI-SCORE ≥8 was associated with an increased risk of 30-day all-cause mortality and all-cause mortality and the composite endpoint assessed at a median follow-up of 186 days (OR: 3.00; 95% CI: 1.38-6.55; HR: 2.17; 95% CI: 1.78-4.13; HR: 2.08, 95% CI: 1.57-2.74, respectively) even after adjustment for procedural success and EuroSCORE II or Society of Thoracic Surgeons Predicted Risk of Mortality. The NYHA functional class improved across all TRI-SCORE values.

CONCLUSIONS: In the TriValve registry, the TRI-SCORE has a suboptimal performance in predicting clinical outcomes. However, a TRISCORE ≥8 is associated with an increased risk of clinical events and a lack of prognostic benefit after successful TTVI.

Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

PMID: 38599688

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