Sex-related characteristics and short-term outcomes of patients undergoing transcatheter tricuspid valve intervention for tricuspid regurgitation

Andrea Scotti, Augustin Coisne, Maurizio Taramasso, Juan F. Granada, Sebastian Ludwig, Josep Rodés-Cabau, Philipp Lurz, Jörg Hausleiter, Neil Fam, Susheel K. Kodali, Joel Rosiene, Ari Feinberg, Alberto Pozzoli, Hannes Alessandrini, Luigi Biasco, Eric Brochet, Paolo Denti, Rodrigo Estévez-Loureiro, Christian Frerker, Edwin C. HoVanessa Monivas, Georg Nickenig, Fabien Praz, Rishi Puri, Horst Sievert, Gilbert H.L. Tang, Martin Andreas, Ralph Stephan Von Bardeleben, Karl Philipp Rommel, Guillem Muntané-Carol, Mara Gavazzoni, Daniel Braun, Benedikt Koell, Daniel Kalbacher, Kim A. Connelly, Jean Michel Juliard, Claudia Harr, Giovanni Pedrazzini, Giulio Russo, François Philippon, Joachim Schofer, Holger Thiele, Matthias Unterhuber, Dominique Himbert, Marina Ureña Alcázar, Mirjam G. Wild, Stephan Windecker, Ulrich Jorde, Francesco Maisano, Martin B. Leon, Rebecca T. Hahn, Azeem Latib

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)822-832
Number of pages11
JournalEuropean heart journal
Volume44
Issue number10
DOIs
StatePublished - Mar 7 2023

Keywords

  • Sex
  • Transcatheter tricuspid valve intervention
  • Tricuspid regurgitation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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