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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
Pearl Toh, 31 Dec 2019
Adding the neuraminidase inhibitor oseltamivir to usual care speeds up recovery from influenza-like illness by a day compared with usual care alone, with even greater benefits seen in older, sicker patients with comorbidities, according to the ALIC4E study.
23 Dec 2019
At a Menarini-sponsored symposium held during the Asian Pacific Society Congress, renowned cardiologist Prof John Camm provided the latest evidence for chronic stable angina with or without concomitant diseases, with a special focus on the antianginal agent ranolazine and combination therapies. The event was chaired and moderated by Dr Dante Morales from the University of the Philippines College of Medicine.
Pearl Toh, 5 days ago
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6 days ago
Testosterone treatment may slightly improve sexual functioning and quality of life in men without underlying organic causes of hypogonadism, but it offers little to no benefit for other common symptoms of ageing, according to a study. In addition, long-term efficacy and safety of this therapy remain unknown.