TRIVALVE Score: A Risk Score for Mortality/Hospitalization Prediction in Patients Undergoing Transcatheter Tricuspid Valve Intervention.
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Russo Giulio, Pedicino Daniela, Pires Marafon Denise, Adamo Marianna, Alessandrini Hannes, Andreas Martin, Braun Daniel, Connelly Kim A, Denti Paolo, Estevez-Loureiro Rodrigo, Fam Neil, Hahn Rebecca T, Harr Claudia, Hausleiter Jörg, Himbert Dominique, Kalbacher Daniel, Ho Edwin, Latib Azeem, Lentini Nicolò, Lubos Edith, Ludwig Sebastian, Lurz Philipp, Metra Marco, Monivas Vanessa, Nickenig Georg, Pastorino Roberta, Pedrazzini Giovanni, Pozzoli Alberto, Praz Fabien, Rodes-Cabau Joseph, Besler Christian, Rommel Karl-Philipp, Schofer Joachim, Scotti Andrea, Piayda Kerstin, Sievert Horst, Tang Gilbert H L, Thiele Holger, Schlotter Florian, von Bardeleben Ralph Stephan, Webb John G, Windecker Stephan, Leon Martin, Enriquez-Sarano Maurice, Maisano Francesco, Crea Filippo, Taramasso Maurizio
Аннотация
OBJECTIVES: The aim of the present study was to propose a dedicated risk score for patients affected by severe TR undergoing TTVI.
METHODS: The score was derived from the TRIVALVE (International Multisite Transcatheter Tricuspid Valve Therapies Registry; NCT03416166) registry, according to data availability. A stepwise model approach was used on predictor variables to develop a scoring system for predicting 12-month mortality or rehospitalization using multivariable logistic regression. Internal discrimination, calibration, and validation were assessed using receiver-operating characteristic curve analysis and bootstrapping with 1,000 resamples.
RESULTS: A total of 483 patients were included in the study, with an overall 12-month mortality or rehospitalization rate of 19% (n = 94). The final risk score, ranging from 0 to 4.5, included the following 5 parameters (adjusted for age and gender): 1) atrial fibrillation at baseline; 2) glomerular filtration rate <30 mL/min; 3) elevated gamma-glutamyl transferase/bilirubin levels; 4) signs of right heart failure; and 5) left ventricular ejection fraction <50%. The bias-corrected area under the receiver-operating characteristic curve was 68% (95% CI: 62%-75%). A cutoff value of 2.5 demonstrated sensitivity of 65.4% and specificity of 60.5% for the outcome.
CONCLUSIONS: The present study proposes a dedicated risk score for patients undergoing TTVI, providing an additional and simple tool for heart teams to select the best therapy for patients affected by severe TR.