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Transcatheter treatment improves survival of patients with severe tricuspid regurgitation

16 Dec 2019

Transcatheter tricuspid valve interventions (TTVI), compared with medical therapy alone, appears to improve survival and reduce rehospitalization due to heart failure (HF), as shown in this propensity-matched, case-control study.

A total of 472 patients from 22 European and North American centres who underwent TTVI from 2016 to 2018 were included in the TriValve (Transcatheter Tricuspid Valve Therapies) registry. A control cohort from two large retrospective registries that enrolled patients with moderate to severe tricuspid regurgitation in Europe and North America (n=1,179) was propensity-score matched 1:1 on the basis of age, EuroSCORE II and systolic pulmonary artery pressure.

Cox regression analysis was used to examine survival. One-year mortality or HF rehospitalization or the composite was the primary endpoint.

Propensity-score matching identified 268 pairs. TTVI patients had lower 1-year mortality (23±3 percent vs 36±3 percent; p=0.001), rehospitalization (26±3 percent vs 47±3 percent; p<0.0001) and composite endpoint (32±4 percent vs 49±3 percent; p=0.0003) than controls.

TTVI correlated with better survival and freedom from HF rehospitalization (hazard ratio [HR], 0.60, 95 percent confidence interval [CI], 0.46–0.79; p-unadjusted=0.003), and this association persisted even after adjusting for sex, New York Heart Association functional class, right ventricular dysfunction and atrial fibrillation (HR, 0.39, 95 percent CI, 0.26–0.59; p<0.0001) and after further adjustment for mitral regurgitation and pacemaker/defibrillator (HR, 0.35, 95 percent CI, 0.23–0.54; p<0.0001).

“Randomized trials should be performed to confirm these results,” the investigators said.

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Most Read Articles
2 days ago
A recent study reports a mean growth rate of proximal aorta of about 0.1 mm/year in hypertensive patients with known aortic dilatation. In addition, those with increased rather than normal aortic z score have slower dilatation over time.
Tristan Manalac, Yesterday
The coronavirus disease 2019 (COVID-19) appears to be more dangerous among cancer patients, who tend suffer more severe complications and faster disease progression, according to a new study.
6 days ago
Knee osteoarthritis (OA), whether symptomatic or radiographic, contributes to an increased risk of all-cause mortality, with the risk increase from symptomatic knee OA partially attributed to its effect on disability and quality of life (QoL).
Yesterday
Cuff-based excess pressure (XSP) is modestly associated with carotid intima–media thickness independent of conventional risk factors, reveals a recent study.