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Background <p>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. </p> Objectives <p>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).</p> Methods <p>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.</p> Results <p>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%; <i>p</i> &lt; 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%).</p> Conclusion <p>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.</p> Graphical abstract <p></p>

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Predictive performance of the TRI-SCORE in patients with severe aortic stenosis and concomitant tricuspid regurgitation undergoing TAVR

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月12日

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  • Mustafa Mousa Basha,
  • Baravan Al-Kassou,
  • Christopher Gestrich,
  • Marcel Weber,
  • Thomas Beiert,
  • Sebastian Zimmer,
  • Farhad Bakhtiary,
  • Georg Nickenig,
  • Jasmin Shamekhi

摘要

Background

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.

Objectives

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).

Methods

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.

Results

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%).

Conclusion

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.

Graphical abstract