Mousa Basha Mustafa, Al-Kassou Baravan, Gestrich Christopher, Weber Marcel, Beiert Thomas, Zimmer Sebastian, Bakhtiary Farhad, Nickenig Georg, Shamekhi Jasmin
Heart Center, Department of Medicine II, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
Heart Center Bonn, Department of Cardiac Surgery, University Hospital Bonn, Bonn, Germany.
Clin Res Cardiol. 2025 May 12. doi: 10.1007/s00392-025-02671-y.
Tricuspid regurgitation (TR) is a common comorbidity in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) and represents a significant predictor of adverse outcomes. Precise risk stratification through clinical scoring systems is vital for tailoring treatment decisions in this patient population.
To assess the applicability of the TRI-SCORE for predicting adverse outcomes in patients with AS and concomitant moderate-to-severe TR undergoing TAVR and to compare its performance with established surgical risk scores like the EuroSCORE II and Society of Thoracic Surgeons score (STS-Score).
We conducted a retrospective analysis of 301 patients with severe AS and concomitant TR who underwent TAVR between 2013 and 2022 at the Heart Center Bonn. According to the TRI-SCORE, patients were stratified into a low or intermediate-risk group (TRI-SCORE 0-5) and a high-risk group (TRI-SCORE 6-12). The primary endpoint was 2-year all-cause mortality. Predictive values of the TRI-SCORE were compared to the EuroSCORE II and the STS-Score for both 30-day and 2-year mortality outcomes.
The 2-year mortality rate was significantly higher in the high-risk group compared to the low or intermediate-risk group (TRI-SCORE 6-12: 40.0% vs. TRI-SCORE 0-5: 17.9%; p < 0.001). For predicting 30-day mortality, the EuroSCORE II and the STS-Score demonstrated superior predictive values, with AUCs of 78.4% and 83.0%, respectively, in comparison to the TRI-SCORE, which showed an AUC of 70.0%. Conversely, the TRI-SCORE allowed a better risk prediction with regard to 2-year all-cause mortality, achieving an AUC of 69.7%, superior to the EuroSCORE II (60.6%) and the STS-Score (62.1%).
The TRI-SCORE is effective in predicting mid-term mortality in patients with AS and moderate-to-severe TR undergoing TAVR, demonstrating greater robustness than the EuroSCORE II and the STS-Score for this timeframe.
三尖瓣反流（TR）是接受经导管主动脉瓣置换术（TAVR）的严重主动脉瓣狭窄（AS）患者的常见合并症，是不良结局的重要预测指标。通过临床评分系统进行精确的风险分层对于为该患者群体制定治疗决策至关重要。
评估TRI-SCORE在预测接受TAVR的AS合并中重度TR患者不良结局中的适用性，并将其性能与既定的手术风险评分（如欧洲心脏手术风险评估系统II（EuroSCORE II）和胸外科医师协会评分（STS评分））进行比较。
我们对2013年至2022年在波恩心脏中心接受TAVR的301例严重AS合并TR患者进行了回顾性分析。根据TRI-SCORE，患者被分为低或中风险组（TRI-SCORE 0-5）和高风险组（TRI-SCORE 6-12）。主要终点是2年全因死亡率。将TRI-SCORE的预测值与EuroSCORE II和STS评分在30天和2年死亡率结局方面进行比较。
高风险组的2年死亡率显著高于低或中风险组（TRI-SCORE 6-12：40.0% 对 TRI-SCORE 0-5：17.9%；p < 0.001）。对于预测30天死亡率，EuroSCORE II和STS评分显示出更高的预测价值，其曲线下面积（AUC）分别为78.4%和83.
