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Sex-related characteristics and short-term outcomes of patients undergoing transcatheter tricuspid valve intervention for tricuspid regurgitation.

European heart journal

Authors: Andrea Scotti, Augustin Coisne, Maurizio Taramasso, Juan F Granada, Sebastian Ludwig, Josep Rodés-Cabau, Philipp Lurz, Jörg Hausleiter, Neil Fam, Susheel K Kodali, Joel Rosiene, Ari Feinberg, Alberto Pozzoli, Hannes Alessandrini, Luigi Biasco, Eric Brochet, Paolo Denti, Rodrigo Estévez-Loureiro, Christian Frerker, Edwin C Ho, Vanessa Monivas, Georg Nickenig, Fabien Praz, Rishi Puri, Horst Sievert, Gilbert H L Tang, Martin Andreas, Ralph Stephan Von Bardeleben, Karl-Philipp Rommel, Guillem Muntané-Carol, Mara Gavazzoni, Daniel Braun, Benedikt Koell, Daniel Kalbacher, Kim A Connelly, Jean-Michel Juliard, Claudia Harr, Giovanni Pedrazzini, Giulio Russo, François Philippon, Joachim Schofer, Holger Thiele, Matthias Unterhuber, Dominique Himbert, Marina Ureña Alcázar, Mirjam G Wild, Stephan Windecker, Ulrich Jorde, Francesco Maisano, Martin B Leon, Rebecca T Hahn, Azeem Latib

AIMS: The impact of sexuality in patients with significant tricuspid regurgitation (TR) undergoing transcatheter tricuspid valve intervention (TTVI) is unknown. The aim of this study was to investigate sex-specific outcomes in patients with significant TR treated with TTVI vs. medical therapy alone.

METHODS AND RESULTS: The Transcatheter Tricuspid Valve Therapies (TriValve) registry collected data on patients with significant TR from 24 centres who underwent TTVI from 2016 to 2021. A control cohort was formed by medically managed patients with ≥severe isolated TR diagnosed in 2015-18. The primary endpoint was freedom from all-cause mortality. Secondary endpoints were heart failure (HF) hospitalization, New York Heart Association (NYHA) functional status, and TR severity. One-year outcomes were assessed for the TriValve cohort and compared with the control cohort with the inverse probability of treatment weighting (IPTW). A total of 556 and 2072 patients were included from the TriValve and control groups, respectively. After TTVI, there was no difference between women and men in 1-year freedom from all-cause mortality 80.9% vs. 77.9%, P = 0.56, nor in HF hospitalization (P = 0.36), NYHA Functional Classes III and IV (P = 0.17), and TR severity >2+ at last follow-up (P = 0.42). Multivariable Cox-regression weighted by IPTW showed improved 1-year survival after TTVI compared with medical therapy alone in both women (adjusted hazard ratio 0.45, 95% confidence interval 0.23-0.83, P = 0.01) and men (adjusted hazard ratio 0.42, 95% confidence interval 0.18-0.89, P = 0.03).

CONCLUSION: After TTVI in high-risk patients, there were no sex-related differences in terms of survival, HF hospitalization, functional status, and TR reduction up to 1 year. The IPTW analysis shows a survival benefit of TTVI over medical therapy alone in both women and men.

© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PMID: 36445158

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