TRI-SCORE 在经导管缘对缘三尖瓣修复术后死亡率预测方面优于 EuroSCORE II 和 STS-Score。
TRI-SCORE is superior to EuroSCORE II and STS-Score in mortality prediction following transcatheter edge-to-edge tricuspid valve repair.
机构信息
Department of Cardiology, Ulm University Heart Center, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
出版信息
Clin Res Cardiol. 2023 Oct;112(10):1436-1445. doi: 10.1007/s00392-023-02246-9. Epub 2023 Jul 5.
BACKGROUND
The development of transcatheter tricuspid edge-to-edge repair for tricuspid regurgitation is a therapeutic milestone but a specific periprocedural risk assessment tool is lacking. TRI-SCORE has recently been introduced as a dedicated risk score for tricuspid valve surgery.
AIMS
This study analyzes the predictive performance of TRI-SCORE following transcatheter edge-to-edge tricuspid valve repair.
METHODS
180 patients who underwent transcatheter tricuspid valve repair at Ulm University Hospital were consecutively included and stratified into three TRI-SCORE risk groups. The predictive performance of TRI-SCORE was assessed throughout a follow-up period of 30 days and up to 1 year.
RESULTS
All patients had severe tricuspid regurgitation. Median EuroSCORE II was 6.4% (IQR 3.8-10.1%), median STS-Score 8.1% (IQR 4.6-13.4%) and median TRI-SCORE 6.0 (IQR 4.0-7.0). 64 patients (35.6%) were in the low TRI-SCORE group, 91 (50.6%) in the intermediate and 25 (13.9%) in the high-risk groups. The procedural success rate was 97.8%. 30-day mortality was 0% in the low-risk group, 1.3% in the intermediate-risk and 17.4% in the high-risk groups (p < 0.001). During a median follow-up of 168 days mortality was 0%, 3.8% and 52.2%, respectively (p < 0.001). The predictive performance of TRI-SCORE was excellent (AUC for 30-day mortality: 90.3%, for one-year mortality: 93.1%) and superior to EuroSCORE II (AUC 56.6% and 64.4%, respectively) and STS-Score (AUC 61.0% and 59.0%, respectively).
CONCLUSION
TRI-SCORE is a valuable tool for prediction of mortality after transcatheter edge-to-edge tricuspid valve repair and its performance is superior to EuroSCORE II and STS-Score. In a monocentric cohort of 180 patients undergoing edge-to-edge tricuspid valve repair TRI-SCORE predicted 30-day and up to one-year mortality more reliably than EuroSCORE II and STS-Score. AUC area under the curve, 95% CI 95% confidence interval.
背景
经导管三尖瓣缘对缘修复术治疗三尖瓣反流是治疗的一个里程碑，但缺乏特定的围手术期风险评估工具。TRI-SCORE 最近被引入作为一种专门用于三尖瓣手术的风险评分。
目的
本研究分析了经导管三尖瓣缘对缘修复术后 TRI-SCORE 的预测性能。
方法
连续纳入在乌尔姆大学医院接受经导管三尖瓣修复术的 180 例患者，并分为三个 TRI-SCORE 风险组。通过 30 天及长达 1 年的随访期评估 TRI-SCORE 的预测性能。
结果
所有患者均有严重的三尖瓣反流。中位 EuroSCORE II 为 6.4%（IQR 3.8-10.1%），中位 STS 评分 8.1%（IQR 4.6-13.4%），中位 TRI-SCORE 6.0（IQR 4.0-7.0）。64 例（35.6%）患者为低 TRI-SCORE 组，91 例（50.6%）为中危组，25 例（13.9%）为高危组。手术成功率为 97.8%。低危组 30 天死亡率为 0%，中危组为 1.3%，高危组为 17.4%（p<0.001）。中位随访 168 天死亡率分别为 0%、3.8%和 52.2%（p<0.001）。TRI-SCORE 的预测性能优异（30 天死亡率的 AUC：90.3%，1 年死亡率的 AUC：93.1%），优于 EuroSCORE II（AUC 分别为 56.6%和 64.4%）和 STS 评分（AUC 分别为 61.0%和 59.0%）。
结论
TRI-SCORE 是预测经导管三尖瓣缘对缘修复术后死亡率的有用工具，其性能优于 EuroSCORE II 和 STS-Score。在接受缘对缘三尖瓣修复术的 180 例患者的单中心队列中，TRI-SCORE 比 EuroSCORE II 和 STS-Score 更可靠地预测 30 天和 1 年的死亡率。AUC 曲线下面积，95%CI 95%置信区间。
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