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TRIVALVE Score: A Risk Score for Mortality/Hospitalization Prediction in Patients Undergoing Transcatheter Tricuspid Valve Intervention.

JACC. Cardiovascular interventions

Authors: Giulio Russo, Daniela Pedicino, Denise Pires Marafon, Marianna Adamo, Hannes Alessandrini, Martin Andreas, Daniel Braun, Kim A Connelly, Paolo Denti, Rodrigo Estevez-Loureiro, Neil Fam, Rebecca T Hahn, Claudia Harr, Jörg Hausleiter, Dominique Himbert, Daniel Kalbacher, Edwin Ho, Azeem Latib, Nicolò Lentini, Edith Lubos, Sebastian Ludwig, Philipp Lurz, Marco Metra, Vanessa Monivas, Georg Nickenig, Roberta Pastorino, Giovanni Pedrazzini, Alberto Pozzoli, Fabien Praz, Joseph Rodes-Cabau, Christian Besler, Karl-Philipp Rommel, Joachim Schofer, Andrea Scotti, Kerstin Piayda, Horst Sievert, Gilbert H L Tang, Holger Thiele, Florian Schlotter, Ralph Stephan von Bardeleben, John G Webb, Stephan Windecker, Martin Leon, Maurice Enriquez-Sarano, Francesco Maisano, Filippo Crea, Maurizio Taramasso

BACKGROUND: Transcatheter tricuspid valve intervention (TTVI) has been increasingly adopted in recent years for the treatment of patients with tricuspid regurgitation (TR). However, no dedicated risk stratification has been established for patients undergoing TTVI.

OBJECTIVES: The aim of the present study was to propose a dedicated risk score for patients affected by severe TR undergoing TTVI.

METHODS: The score was derived from the TRIVALVE (International Multisite Transcatheter Tricuspid Valve Therapies Registry; NCT03416166) registry, according to data availability. A stepwise model approach was used on predictor variables to develop a scoring system for predicting 12-month mortality or rehospitalization using multivariable logistic regression. Internal discrimination, calibration, and validation were assessed using receiver-operating characteristic curve analysis and bootstrapping with 1,000 resamples.

RESULTS: A total of 483 patients were included in the study, with an overall 12-month mortality or rehospitalization rate of 19% (n = 94). The final risk score, ranging from 0 to 4.5, included the following 5 parameters (adjusted for age and gender): 1) atrial fibrillation at baseline; 2) glomerular filtration rate <30 mL/min; 3) elevated gamma-glutamyl transferase/bilirubin levels; 4) signs of right heart failure; and 5) left ventricular ejection fraction <50%. The bias-corrected area under the receiver-operating characteristic curve was 68% (95% CI: 62%-75%). A cutoff value of 2.5 demonstrated sensitivity of 65.4% and specificity of 60.5% for the outcome.

CONCLUSIONS: The present study proposes a dedicated risk score for patients undergoing TTVI, providing an additional and simple tool for heart teams to select the best therapy for patients affected by severe TR.

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

PMID: 39322365

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