Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Department of Biomedicine and Prevention, Cardiology Unit, Policlinico Tor Vergata, University of Rome, Rome, Italy.
JACC Cardiovasc Interv. 2024 Apr 8;17(7):859-870. doi: 10.1016/j.jcin.2024.02.013.
Data on the prognostic role of the TRI-SCORE in patients undergoing transcatheter tricuspid valve intervention (TTVI) are limited.
The aim of this study was to evaluate the performance of the TRI-SCORE in predicting outcomes of patients undergoing TTVI.
TriValve (Transcatheter Tricuspid Valve Therapies) is a large multicenter multinational registry including patients undergoing TTVI. The TRI-SCORE is a risk model recently proposed to predict in-hospital mortality after tricuspid valve surgery. The TriValve population was stratified based on the TRI-SCORE tertiles. The outcomes of interest were all-cause death and all-cause death or heart failure hospitalization. Procedural complications and changes in NYHA functional class were also reported.
Among the 634 patients included, 223 patients (35.2%) had a TRI-SCORE between 0 and 5, 221 (34.8%) had 6 or 7, and 190 (30%) had ≥8 points. Postprocedural blood transfusion, acute kidney injury, new atrial fibrillation, and in-hospital mortality were more frequent in the highest TRI-SCORE tertile. Postprocedure length of stay increased with a TRI-SCORE increase. A TRI-SCORE ≥8 was associated with an increased risk of 30-day all-cause mortality and all-cause mortality and the composite endpoint assessed at a median follow-up of 186 days (OR: 3.00; 95% CI: 1.38-6.55; HR: 2.17; 95% CI: 1.78-4.13; HR: 2.08, 95% CI: 1.57-2.74, respectively) even after adjustment for procedural success and EuroSCORE II or Society of Thoracic Surgeons Predicted Risk of Mortality. The NYHA functional class improved across all TRI-SCORE values.
In the TriValve registry, the TRI-SCORE has a suboptimal performance in predicting clinical outcomes. However, a TRISCORE ≥8 is associated with an increased risk of clinical events and a lack of prognostic benefit after successful TTVI.
关于 TRI-SCORE 在接受经导管三尖瓣介入治疗（TTVI）的患者中的预后作用的数据有限。
本研究旨在评估 TRI-SCORE 在预测 TTVI 患者结局中的表现。
TriValve（经导管三尖瓣治疗）是一项大型多中心多国注册研究，纳入了接受 TTVI 的患者。TRI-SCORE 是一种最近提出的风险模型，用于预测三尖瓣手术后住院期间的死亡率。根据 TRI-SCORE 三分位数对 TriValve 人群进行分层。感兴趣的结局是全因死亡和全因死亡或心力衰竭住院。还报告了程序并发症和纽约心脏协会（NYHA）功能分级的变化。
在纳入的 634 名患者中，223 名（35.2%）患者的 TRI-SCORE 为 0 至 5，221 名（34.8%）为 6 或 7，190 名（30%）为≥8 分。在最高 TRI-SCORE 三分位数中，术后输血、急性肾损伤、新发心房颤动和住院期间死亡率较高。随着 TRI-SCORE 的增加，术后住院时间延长。TRI-SCORE≥8 与 30 天全因死亡率和全因死亡率和在中位数随访 186 天评估的复合终点相关增加风险（OR：3.00；95%CI：1.38-6.55；HR：2.17；95%CI：1.78-4.13；HR：2.08，95%CI：1.57-2.74，分别），即使在调整手术成功率和欧洲心脏手术风险评分或胸外科医生预测死亡率后也是如此。NYHA 功能分级在所有 TRI-SCORE 值中均有所改善。
在 TriValve 登记研究中，TRI-SCORE 在预测临床结局方面表现不佳。然而，TRI-SCORE≥8 与 TTVI 后临床事件风险增加和缺乏预后获益相关。
