B-55 | Impact of Baseline Tricuspid Regurgitation on Health Status and Clinical Outcomes After Transcatheter Aortic Valve Replacement: Insights from the STS/ACC TVT Registry

Abstract

Tricuspid regurgitation (TR) is associated with worse clinical outcomes after TAVR. Little is known about the association between TR and health status outcomes after TAVR. Health status was assessed with the Kansas City Cardiomyopathy Questionnaire overall summary score (KCCQ-OS) in patients enrolled in the STS/ACC TVT Registry who underwent isolated TAVR between Jan 2019-Jun 2021. Multivariable logistic and cox regression models were used to evaluate the association of TR with being alive and well and clinical outcomes (deaths and readmission) respectively at 1 year. We included 130,097 patients who underwent TAVR (mean age 79.2±8.3 years, STS score 5.3±4.6%, 56.2% men, 13.1% moderate TR, 2.3% severe TR). Mean baseline KCCQ-OS was significantly lower in patients with severe vs moderate vs none/trace/mild TR (39.4±24.2 vs 45.2±24.7 vs 51.3±25.3; p<0.0001). Greater baseline TR was also associated with lower KCCQ-OS at 30 days and 1 year (Figure A). Compared with patients with none/trace/mild TR, moderate, and severe TR had lower odds of being alive and well at 1 year after TAVR [adjOR 0.79 (0.74-0.85); adjOR 0.81 (0.70-0.94), respectively; Figure B]. Further, moderate, and severe TR were both associated with higher mortality [adjHR 1.24 (1.15-1.34); adjHR 1.65 (1.46-1.86)], and readmission [adjHR 1.07 (1.01-1.12); adjHR 1.11 (1.01-1.21)] at 1 year in comparison with none/trace/mild TR (Figure C). The presence of baseline moderate or severe TR is associated with worse health status and clinical outcomes after TAVR. Future studies should focus on whether treatment of baseline TR improves outcomes among TAVR recipients.