Sex-Related Characteristics and Short-Term Outcomes of Patients Undergoing Transcatheter Tricuspid Valve Intervention for Tricuspid Regurgitation

TY - JOUR

T1 - Sex-Related Characteristics and Short-Term Outcomes of Patients Undergoing Transcatheter Tricuspid Valve Intervention for Tricuspid Regurgitation

AU - Scotti, Andrea

AU - Coisne, Augustin

AU - Taramasso, Maurizio

AU - Granada, Juan F

AU - Ludwig, Sebastian

AU - Rodés-Cabau, Josep

AU - Lurz, Philipp

AU - Hausleiter, Jörg

AU - Fam, Neil

AU - Kodali, Susheel K

AU - Rosiene, Joel

AU - Feinberg, Ari

AU - Pozzoli, Alberto

AU - Alessandrini, Hannes

AU - Biasco, Luigi

AU - Brochet, Eric

AU - Denti, Paolo

AU - Estevez-Loureiro, Rodrigo

AU - Frerker, Christian

AU - Ho, Edwin C

AU - Monivas, Vanessa

AU - Nickenig, Georg

AU - Praz, Fabien

AU - Puri, Rishi

AU - Sievert, Horst

AU - Tang, Gilbert H L

AU - Andreas, Martin

AU - Von Bardeleben, Ralph Stephan

AU - Rommel, Karl-Philipp

AU - Muntané-Carol, Guillem

AU - Gavazzoni, Mara

AU - Braun, Daniel

AU - Koell, Benedikt

AU - Kalbacher, Daniel

AU - Connelly, Kim A

AU - Juliard, Jean-Michel

AU - Harr, Claudia

AU - Pedrazzini, Giovanni

AU - Russo, Giulio

AU - Philippon, François

AU - Schofer, Joachim

AU - Thiele, Holger

AU - Unterhuber, Matthias

AU - Himbert, Dominique

AU - Alcázar, Marina Ureña

AU - Wild, Mirjam G

AU - Windecker, Stephan

AU - Jorde, Ulrich

AU - Maisano, Francesco

AU - Leon, Martin B

AU - Hahn, Rebecca T

AU - Latib, Azeem

AU - TriValve Registry

N1 - © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PY - 2023/3/7

Y1 - 2023/3/7

N2 - AIMS: The impact of sexuality in patients with significant tricuspid regurgitation (TR) undergoing transcatheter tricuspid valve intervention (TTVI) is unknown. The aim of this study was to investigate sex-specific outcomes in patients with significant TR treated with TTVI vs. medical therapy alone.METHODS AND RESULTS: The Transcatheter Tricuspid Valve Therapies (TriValve) registry collected data on patients with significant TR from 24 centres who underwent TTVI from 2016 to 2021. A control cohort was formed by medically managed patients with ≥severe isolated TR diagnosed in 2015-18. The primary endpoint was freedom from all-cause mortality. Secondary endpoints were heart failure (HF) hospitalization, New York Heart Association (NYHA) functional status, and TR severity. One-year outcomes were assessed for the TriValve cohort and compared with the control cohort with the inverse probability of treatment weighting (IPTW). A total of 556 and 2072 patients were included from the TriValve and control groups, respectively. After TTVI, there was no difference between women and men in 1-year freedom from all-cause mortality 80.9% vs. 77.9%, P = 0.56, nor in HF hospitalization (P = 0.36), NYHA Functional Classes III and IV (P = 0.17), and TR severity >2+ at last follow-up (P = 0.42). Multivariable Cox-regression weighted by IPTW showed improved 1-year survival after TTVI compared with medical therapy alone in both women (adjusted hazard ratio 0.45, 95% confidence interval 0.23-0.83, P = 0.01) and men (adjusted hazard ratio 0.42, 95% confidence interval 0.18-0.89, P = 0.03).CONCLUSION: After TTVI in high-risk patients, there were no sex-related differences in terms of survival, HF hospitalization, functional status, and TR reduction up to 1 year. The IPTW analysis shows a survival benefit of TTVI over medical therapy alone in both women and men.

AB - AIMS: The impact of sexuality in patients with significant tricuspid regurgitation (TR) undergoing transcatheter tricuspid valve intervention (TTVI) is unknown. The aim of this study was to investigate sex-specific outcomes in patients with significant TR treated with TTVI vs. medical therapy alone.METHODS AND RESULTS: The Transcatheter Tricuspid Valve Therapies (TriValve) registry collected data on patients with significant TR from 24 centres who underwent TTVI from 2016 to 2021. A control cohort was formed by medically managed patients with ≥severe isolated TR diagnosed in 2015-18. The primary endpoint was freedom from all-cause mortality. Secondary endpoints were heart failure (HF) hospitalization, New York Heart Association (NYHA) functional status, and TR severity. One-year outcomes were assessed for the TriValve cohort and compared with the control cohort with the inverse probability of treatment weighting (IPTW). A total of 556 and 2072 patients were included from the TriValve and control groups, respectively. After TTVI, there was no difference between women and men in 1-year freedom from all-cause mortality 80.9% vs. 77.9%, P = 0.56, nor in HF hospitalization (P = 0.36), NYHA Functional Classes III and IV (P = 0.17), and TR severity >2+ at last follow-up (P = 0.42). Multivariable Cox-regression weighted by IPTW showed improved 1-year survival after TTVI compared with medical therapy alone in both women (adjusted hazard ratio 0.45, 95% confidence interval 0.23-0.83, P = 0.01) and men (adjusted hazard ratio 0.42, 95% confidence interval 0.18-0.89, P = 0.03).CONCLUSION: After TTVI in high-risk patients, there were no sex-related differences in terms of survival, HF hospitalization, functional status, and TR reduction up to 1 year. The IPTW analysis shows a survival benefit of TTVI over medical therapy alone in both women and men.

U2 - 10.1093/eurheartj/ehac735

DO - 10.1093/eurheartj/ehac735

M3 - SCORING: Journal article

C2 - 36445158

VL - 44

SP - 822

EP - 832

JO - EUR HEART J

JF - EUR HEART J

SN - 0195-668X

IS - 10

ER -