Log in to MyACC
Sex-Specific Outcomes of Transcatheter Tricuspid Valve Intervention for TR
Quick Takes
- There were no sex-based differences in survival, HF hospitalization, functional status, and tricuspid regurgitation (TR) reduction up to 1 year among patients undergoing transcatheter tricuspid valve intervention (TTVI) for severe TR.
- TTVI was associated with a significant survival benefit compared to medical therapy irrespective of sex.
Study Questions:
What are sex-specific outcomes in patients with significant tricuspid regurgitation (TR) treated with transcatheter tricuspid valve intervention (TTVI)?
Methods:
The TriValve (Transcatheter Tricuspid Valve Therapies) registry enrolled patients with significant TR from 24 centers who underwent TTVI from 2016–2021. Medically managed patients with severe isolated TR diagnosed in 2015–2018 were identified as the control group. 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).
Results:
A total of 556 and 2,072 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 class III-IV (p = 0.17), and TR severity >2+ at last follow-up (p = 0.42). Multivariable Cox-regression weighted by IPTW showed an improved 1-year survival after TTVI compared to medical therapy alone in both women (adjusted hazard ratio [HR], 0.45; 95% confidence interval [CI], 0.23-0.83; p = 0.01) and men (adjusted HR, 0.42; 95% CI, 0.18-0.89; p = 0.03).
Conclusions:
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.
Perspective:
Findings from the TriValve registry show survival benefit of TTVI over medical therapy regardless of sex. There also were no differences between men and women with respect to HF admission, functional status, and TR reduction. Barring limitations of study design, TTVI may represent a viable treatment option in a selected population of men and women with severe TR.
Clinical Topics: Cardiac Surgery, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Valvular Heart Disease, Cardiac Surgery and Heart Failure, Cardiac Surgery and VHD, Acute Heart Failure, Interventions and Structural Heart Disease
Keywords: Functional Status, Heart Failure, Heart Valve Diseases, Sex Characteristics, Survival, Transcatheter Aortic Valve Replacement, Treatment Outcome, Tricuspid Valve Insufficiency
< Back to Listings
