Patients with moderate or severe tricuspid regurgitation (TR) prior to undergoing TAVR or mitral transcatheter edge-to-edge repair (TEER), when compared to patients with no or mild TR, were associated with worse health status and clinical outcomes, according to a study published in JACC: Cardiovascular Interventions.

Including 130,097 TAVR patients (13.1% with moderate TR, 2.3% with severe TR) and 19,593 mitral TEER patients (33.2% with moderate TR, 14.7% with severe TR) from the STS/ACC TVT Registry, Yasser M. Sammour, MD, MSc, et al., examined the association among baseline TR and Kansas City Cardiomyopathy Questionnaire (KCCQ) overall summary scores, being alive and well, and clinical outcomes such as one-year mortality and hospital readmission.

Patients with moderate or severe TR prior to TAVR or mitral TEER were found to have lower KCCQ overall summary scores prior to intervention as well as at 30-day and one-year follow-up.

Results showed that patients with moderate or severe TR before TAVR were less likely to be alive and well at one year (adjusted odds ratio [OR], 0.79 [95% CI, 0.74-0.85] and adjusted OR, 0.81 [95% CI, 0.70-0.94], respectively). Similar results were noted for patients with severe TR prior to mitral TEER (adjusted OR, 0.53; 95% CI. 0.40-0.71).

Additionally, the authors found that moderate or severe TR prior to TAVR was associated with higher one-year mortality and readmission, and moderate or severe TR prior to mitral TEER was associated with higher one-year mortality.

Study limitations include its retrospective, observational design; potential reporting errors in the quantification of baseline TR severity; and the lack of access to Centers for Medicare and Medicaid Services administrative claims data, forcing the authors to rely on available follow-up data from the registry.

“The incorporation of TR severity into risk prediction models before these procedures may be warranted,” write the authors. “These considerations become especially important during the growing era of transcatheter tricuspid therapies, which could render many nonsurgical candidates with significant TR eligible for interventions.”

Keywords: National Cardiovascular Data Registries, STS/ACC TVT Registry