Transcatheter Versus Medical Treatment of Patients With Symptomatic Severe Tricuspid Regurgitation
Standard
Transcatheter Versus Medical Treatment of Patients With Symptomatic Severe Tricuspid Regurgitation. / Taramasso, Maurizio; Benfari, Giovanni; van der Bijl, Pieter; Alessandrini, Hannes; Attinger-Toller, Adrian; Biasco, Luigi; Lurz, Philipp; Braun, Daniel; Brochet, Eric; Connelly, Kim A; de Bruijn, Sabine; Denti, Paolo; Deuschl, Florian; Estevez-Loureiro, Rodrigo; Fam, Neil; Frerker, Christian; Gavazzoni, Mara; Hausleiter, Jörg; Ho, Edwin; Juliard, Jean-Michel; Kaple, Ryan; Besler, Christian; Kodali, Susheel; Kreidel, Felix; Kuck, Karl-Heinz; Latib, Azeem; Lauten, Alexander; Monivas, Vanessa; Mehr, Michael; Muntané-Carol, Guillem; Nazif, Tamin; Nickening, Georg; Pedrazzini, Giovanni; Philippon, François; Pozzoli, Alberto; Praz, Fabien; Puri, Rishi; Rodés-Cabau, Josep; Schäfer, Ulrich; Schofer, Joachim; Sievert, Horst; Tang, Gilbert H L; Thiele, Holger; Topilsky, Yan; Rommel, Karl-Philipp; Delgado, Victoria; Vahanian, Alec; Von Bardeleben, Ralph Stephan; Webb, John G; Weber, Marcel; Windecker, Stephan; Winkel, Mirjam; Zuber, Michel; Leon, Martin B; Hahn, Rebecca T; Bax, Jeroen J; Enriquez-Sarano, Maurice; Maisano, Francesco.
in: J AM COLL CARDIOL, Jahrgang 74, Nr. 24, 17.12.2019, S. 2998-3008.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Transcatheter Versus Medical Treatment of Patients With Symptomatic Severe Tricuspid Regurgitation
AU - Taramasso, Maurizio
AU - Benfari, Giovanni
AU - van der Bijl, Pieter
AU - Alessandrini, Hannes
AU - Attinger-Toller, Adrian
AU - Biasco, Luigi
AU - Lurz, Philipp
AU - Braun, Daniel
AU - Brochet, Eric
AU - Connelly, Kim A
AU - de Bruijn, Sabine
AU - Denti, Paolo
AU - Deuschl, Florian
AU - Estevez-Loureiro, Rodrigo
AU - Fam, Neil
AU - Frerker, Christian
AU - Gavazzoni, Mara
AU - Hausleiter, Jörg
AU - Ho, Edwin
AU - Juliard, Jean-Michel
AU - Kaple, Ryan
AU - Besler, Christian
AU - Kodali, Susheel
AU - Kreidel, Felix
AU - Kuck, Karl-Heinz
AU - Latib, Azeem
AU - Lauten, Alexander
AU - Monivas, Vanessa
AU - Mehr, Michael
AU - Muntané-Carol, Guillem
AU - Nazif, Tamin
AU - Nickening, Georg
AU - Pedrazzini, Giovanni
AU - Philippon, François
AU - Pozzoli, Alberto
AU - Praz, Fabien
AU - Puri, Rishi
AU - Rodés-Cabau, Josep
AU - Schäfer, Ulrich
AU - Schofer, Joachim
AU - Sievert, Horst
AU - Tang, Gilbert H L
AU - Thiele, Holger
AU - Topilsky, Yan
AU - Rommel, Karl-Philipp
AU - Delgado, Victoria
AU - Vahanian, Alec
AU - Von Bardeleben, Ralph Stephan
AU - Webb, John G
AU - Weber, Marcel
AU - Windecker, Stephan
AU - Winkel, Mirjam
AU - Zuber, Michel
AU - Leon, Martin B
AU - Hahn, Rebecca T
AU - Bax, Jeroen J
AU - Enriquez-Sarano, Maurice
AU - Maisano, Francesco
N1 - Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2019/12/17
Y1 - 2019/12/17
N2 - BACKGROUND: Tricuspid regurgitation is associated with increased rates of heart failure (HF) and mortality. Transcatheter tricuspid valve interventions (TTVI) are promising, but the clinical benefit is unknown.OBJECTIVES: The purpose of this study was to investigate the potential benefit of TTVI over medical therapy in a propensity score matched population.METHODS: The TriValve (Transcatheter Tricuspid Valve Therapies) registry collected 472 patients from 22 European and North American centers who underwent TTVI from 2016 to 2018. A control cohort formed by 2 large retrospective registries enrolling medically managed patients with ≥ moderate tricuspid regurgitation in Europe and North America (n = 1,179) were propensity score 1:1 matched (distance ± 0.2 SD) using age, EuroSCORE II, and systolic pulmonary artery pressure. Survival was tested with Cox regression analysis. Primary endpoint was 1-year mortality or HF rehospitalization or the composite.RESULTS: After matching, 268 adequately matched pairs of patients were identified. Compared with control subjects, TTVI patients had lower 1-year mortality (23 ± 3% vs. 36 ± 3%; p = 0.001), rehospitalization (26 ± 3% vs. 47 ± 3%; p < 0.0001), and composite endpoint (32 ± 4% vs. 49 ± 3%; p = 0.0003). TTVI was associated with greater survival and freedom from HF rehospitalization (hazard ratio [HR]: 0.60; 95% confidence interval [CI]: 0.46 to 0.79; p = 0.003 unadjusted), which remained significant after adjusting for sex, New York Heart Association functional class, right ventricular dysfunction, and atrial fibrillation (HR: 0.39; 95% CI: 0.26 to 0.59; p < 0.0001) and after further adjustment for mitral regurgitation and pacemaker/defibrillator (HR: 0.35; 95% CI: 0.23 to 0.54; p < 0.0001).CONCLUSIONS: In this propensity-matched case-control study, TTVI is associated with greater survival and reduced HF rehospitalization compared with medical therapy alone. Randomized trials should be performed to confirm these results.
AB - BACKGROUND: Tricuspid regurgitation is associated with increased rates of heart failure (HF) and mortality. Transcatheter tricuspid valve interventions (TTVI) are promising, but the clinical benefit is unknown.OBJECTIVES: The purpose of this study was to investigate the potential benefit of TTVI over medical therapy in a propensity score matched population.METHODS: The TriValve (Transcatheter Tricuspid Valve Therapies) registry collected 472 patients from 22 European and North American centers who underwent TTVI from 2016 to 2018. A control cohort formed by 2 large retrospective registries enrolling medically managed patients with ≥ moderate tricuspid regurgitation in Europe and North America (n = 1,179) were propensity score 1:1 matched (distance ± 0.2 SD) using age, EuroSCORE II, and systolic pulmonary artery pressure. Survival was tested with Cox regression analysis. Primary endpoint was 1-year mortality or HF rehospitalization or the composite.RESULTS: After matching, 268 adequately matched pairs of patients were identified. Compared with control subjects, TTVI patients had lower 1-year mortality (23 ± 3% vs. 36 ± 3%; p = 0.001), rehospitalization (26 ± 3% vs. 47 ± 3%; p < 0.0001), and composite endpoint (32 ± 4% vs. 49 ± 3%; p = 0.0003). TTVI was associated with greater survival and freedom from HF rehospitalization (hazard ratio [HR]: 0.60; 95% confidence interval [CI]: 0.46 to 0.79; p = 0.003 unadjusted), which remained significant after adjusting for sex, New York Heart Association functional class, right ventricular dysfunction, and atrial fibrillation (HR: 0.39; 95% CI: 0.26 to 0.59; p < 0.0001) and after further adjustment for mitral regurgitation and pacemaker/defibrillator (HR: 0.35; 95% CI: 0.23 to 0.54; p < 0.0001).CONCLUSIONS: In this propensity-matched case-control study, TTVI is associated with greater survival and reduced HF rehospitalization compared with medical therapy alone. Randomized trials should be performed to confirm these results.
KW - Aged
KW - Aged, 80 and over
KW - Cardiac Surgical Procedures/mortality
KW - Case-Control Studies
KW - Echocardiography
KW - Endovascular Procedures/mortality
KW - Europe/epidemiology
KW - Female
KW - Humans
KW - Male
KW - North America/epidemiology
KW - Registries
KW - Tricuspid Valve/diagnostic imaging
KW - Tricuspid Valve Insufficiency/drug therapy
U2 - 10.1016/j.jacc.2019.09.028
DO - 10.1016/j.jacc.2019.09.028
M3 - SCORING: Journal article
C2 - 31568868
VL - 74
SP - 2998
EP - 3008
JO - J AM COLL CARDIOL
JF - J AM COLL CARDIOL
SN - 0735-1097
IS - 24
ER -