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Transcatheter Versus Medical Treatment of Patients With Symptomatic Severe Tricuspid Regurgitation

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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, Vol. 74, No. 24, 17.12.2019, p. 2998-3008.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Taramasso, M, Benfari, G, van der Bijl, P, Alessandrini, H, Attinger-Toller, A, Biasco, L, Lurz, P, Braun, D, Brochet, E, Connelly, KA, de Bruijn, S, Denti, P, Deuschl, F, Estevez-Loureiro, R, Fam, N, Frerker, C, Gavazzoni, M, Hausleiter, J, Ho, E, Juliard, J-M, Kaple, R, Besler, C, Kodali, S, Kreidel, F, Kuck, K-H, Latib, A, Lauten, A, Monivas, V, Mehr, M, Muntané-Carol, G, Nazif, T, Nickening, G, Pedrazzini, G, Philippon, F, Pozzoli, A, Praz, F, Puri, R, Rodés-Cabau, J, Schäfer, U, Schofer, J, Sievert, H, Tang, GHL, Thiele, H, Topilsky, Y, Rommel, K-P, Delgado, V, Vahanian, A, Von Bardeleben, RS, Webb, JG, Weber, M, Windecker, S, Winkel, M, Zuber, M, Leon, MB, Hahn, RT, Bax, JJ, Enriquez-Sarano, M & Maisano, F 2019, 'Transcatheter Versus Medical Treatment of Patients With Symptomatic Severe Tricuspid Regurgitation', J AM COLL CARDIOL, vol. 74, no. 24, pp. 2998-3008. https://doi.org/10.1016/j.jacc.2019.09.028

APA

Taramasso, M., Benfari, G., van der Bijl, P., Alessandrini, H., Attinger-Toller, A., Biasco, L., Lurz, P., Braun, D., Brochet, E., Connelly, K. A., de Bruijn, S., Denti, P., Deuschl, F., Estevez-Loureiro, R., Fam, N., Frerker, C., Gavazzoni, M., Hausleiter, J., Ho, E., ... Maisano, F. (2019). Transcatheter Versus Medical Treatment of Patients With Symptomatic Severe Tricuspid Regurgitation. J AM COLL CARDIOL, 74(24), 2998-3008. https://doi.org/10.1016/j.jacc.2019.09.028

Vancouver

Taramasso M, Benfari G, van der Bijl P, Alessandrini H, Attinger-Toller A, Biasco L et al. Transcatheter Versus Medical Treatment of Patients With Symptomatic Severe Tricuspid Regurgitation. J AM COLL CARDIOL. 2019 Dec 17;74(24):2998-3008. https://doi.org/10.1016/j.jacc.2019.09.028

Bibtex

@article{73c642413f864f72aba2f6dae09c31ac,
title = "Transcatheter Versus Medical Treatment of Patients With Symptomatic Severe Tricuspid Regurgitation",
abstract = "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.",
keywords = "Aged, Aged, 80 and over, Cardiac Surgical Procedures/mortality, Case-Control Studies, Echocardiography, Endovascular Procedures/mortality, Europe/epidemiology, Female, Humans, Male, North America/epidemiology, Registries, Tricuspid Valve/diagnostic imaging, Tricuspid Valve Insufficiency/drug therapy",
author = "Maurizio Taramasso and Giovanni Benfari and {van der Bijl}, Pieter and Hannes Alessandrini and Adrian Attinger-Toller and Luigi Biasco and Philipp Lurz and Daniel Braun and Eric Brochet and Connelly, {Kim A} and {de Bruijn}, Sabine and Paolo Denti and Florian Deuschl and Rodrigo Estevez-Loureiro and Neil Fam and Christian Frerker and Mara Gavazzoni and J{\"o}rg Hausleiter and Edwin Ho and Jean-Michel Juliard and Ryan Kaple and Christian Besler and Susheel Kodali and Felix Kreidel and Karl-Heinz Kuck and Azeem Latib and Alexander Lauten and Vanessa Monivas and Michael Mehr and Guillem Muntan{\'e}-Carol and Tamin Nazif and Georg Nickening and Giovanni Pedrazzini and Fran{\c c}ois Philippon and Alberto Pozzoli and Fabien Praz and Rishi Puri and Josep Rod{\'e}s-Cabau and Ulrich Sch{\"a}fer and Joachim Schofer and Horst Sievert and Tang, {Gilbert H L} and Holger Thiele and Yan Topilsky and Karl-Philipp Rommel and Victoria Delgado and Alec Vahanian and {Von Bardeleben}, {Ralph Stephan} and Webb, {John G} and Marcel Weber and Stephan Windecker and Mirjam Winkel and Michel Zuber and Leon, {Martin B} and Hahn, {Rebecca T} and Bax, {Jeroen J} and Maurice Enriquez-Sarano and Francesco Maisano",
note = "Copyright {\textcopyright} 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.",
year = "2019",
month = dec,
day = "17",
doi = "10.1016/j.jacc.2019.09.028",
language = "English",
volume = "74",
pages = "2998--3008",
journal = "J AM COLL CARDIOL",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "24",

}

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 -