Impact of tricuspid valve regurgitation in surgical high-risk patients undergoing MitraClip implantation: results from the TRAMI registry
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Impact of tricuspid valve regurgitation in surgical high-risk patients undergoing MitraClip implantation: results from the TRAMI registry. / Kalbacher, Daniel; Schäfer, Ulrich; von Bardeleben, R Stephan; Zuern, Christine S; Bekeredjian, Raffi; Ouarrak, Taoufik; Sievert, Horst; Nickenig, Georg; Boekstegers, Peter; Senges, Jochen; Schillinger, Wolfgang; Lubos, Edith.
in: EUROINTERVENTION, Jahrgang 12, Nr. 15, 03.02.2017, S. 1809-1816.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung
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TY - JOUR
T1 - Impact of tricuspid valve regurgitation in surgical high-risk patients undergoing MitraClip implantation: results from the TRAMI registry
AU - Kalbacher, Daniel
AU - Schäfer, Ulrich
AU - von Bardeleben, R Stephan
AU - Zuern, Christine S
AU - Bekeredjian, Raffi
AU - Ouarrak, Taoufik
AU - Sievert, Horst
AU - Nickenig, Georg
AU - Boekstegers, Peter
AU - Senges, Jochen
AU - Schillinger, Wolfgang
AU - Lubos, Edith
PY - 2017/2/3
Y1 - 2017/2/3
N2 - AIMS: We sought to assess the impact of tricuspid regurgitation (TR) severity on patient outcome in a collective with relevant mitral regurgitation undergoing MitraClip implantation..METHODS AND RESULTS: From August 2010 to July 2013, 766 patients (age 75.3±8.5 years, 61% male, median EuroSCORE 24.3%±18.4) were prospectively enrolled in the TRAMI registry and stratified by echocardiography into no/mild, moderate and severe TR. Overall, the mean number of implanted MitraClips was higher in patients with severe TR but increasing TR severity was not associated with procedural success. In-hospital and one-year mortality as well as MACE and MACCE (death, myocardial infarction±stroke) rates were higher with increasing TR severity. Kaplan-Meier curves indicated a significant difference for mortality (p<0.0001), but not for rehospitalisation for heart failure. After multivariate Cox regression, severe TR proved to be a predictor for one-year mortality (HR 2.01, 95% CI: 1.25-3.26, p=0.004). Higher rates of severe bleeding were more frequent with increasing TR grades.CONCLUSIONS: In patients with MitraClip implantation, increasing TR severity is associated with adverse outcome, higher bleeding rates and decreased survival rates.
AB - AIMS: We sought to assess the impact of tricuspid regurgitation (TR) severity on patient outcome in a collective with relevant mitral regurgitation undergoing MitraClip implantation..METHODS AND RESULTS: From August 2010 to July 2013, 766 patients (age 75.3±8.5 years, 61% male, median EuroSCORE 24.3%±18.4) were prospectively enrolled in the TRAMI registry and stratified by echocardiography into no/mild, moderate and severe TR. Overall, the mean number of implanted MitraClips was higher in patients with severe TR but increasing TR severity was not associated with procedural success. In-hospital and one-year mortality as well as MACE and MACCE (death, myocardial infarction±stroke) rates were higher with increasing TR severity. Kaplan-Meier curves indicated a significant difference for mortality (p<0.0001), but not for rehospitalisation for heart failure. After multivariate Cox regression, severe TR proved to be a predictor for one-year mortality (HR 2.01, 95% CI: 1.25-3.26, p=0.004). Higher rates of severe bleeding were more frequent with increasing TR grades.CONCLUSIONS: In patients with MitraClip implantation, increasing TR severity is associated with adverse outcome, higher bleeding rates and decreased survival rates.
KW - Aged
KW - Aged, 80 and over
KW - Cardiac Catheterization/methods
KW - Female
KW - Heart Valve Prosthesis
KW - Heart Valve Prosthesis Implantation/methods
KW - Humans
KW - Male
KW - Middle Aged
KW - Mitral Valve Insufficiency/surgery
KW - Prospective Studies
KW - Registries
KW - Risk
KW - Severity of Illness Index
KW - Treatment Outcome
KW - Tricuspid Valve Insufficiency/surgery
U2 - 10.4244/EIJ-D-16-00850
DO - 10.4244/EIJ-D-16-00850
M3 - SCORING: Journal article
C2 - 28089952
VL - 12
SP - 1809
EP - 1816
JO - EUROINTERVENTION
JF - EUROINTERVENTION
SN - 1774-024X
IS - 15
ER -