Key result
A higher GWTG-HF risk score was independently associated with an increased risk of the composite endpoint of heart failure hospitalization or mortality at 1 year (HR 1.04 per 1-point increase).
Why the study?
The GWTG-HF score predicts mortality in HF patients, but its role for risk stratification in HF patients with tricuspid regurgitation undergoing TTVR required evaluation.
Does the GWTG-HF score predict mortality and hospitalization for heart failure in HF patients with severe TR undergoing TTVR?
Observational (n=181)
No
Does the GWTG-HF score predict mortality and hospitalization for heart failure in HF patients with severe TR undergoing TTVR?
Hazard Ratio: 1.04 (95% CI 1.004–1.08)
p-value: p=0.029
The GWTG-HF score maintains its prognostic value for predicting mortality and heart failure hospitalization in patients with severe tricuspid regurgitation undergoing trans-catheter tricuspid valve repair.
May aid pre-TTVR risk stratification in severe TR; extends GWTG-HF validation but remains hypothesis-generating.
The Get-With-The-Guidelines-Heart-Failure (GWTG-HF) score is a risk assessment tool to predict mortality in patients with heart-failure (HF). We aimed to evaluate the GWTG-HF score for risk stratification in HF patients with tricuspid regurgitation undergoing trans-catheter tricuspid valve repair (TTVR). In total, 181 patients who underwent TTVR via edge-to-edge repair (86%) or annuloplasty (14%) were enrolled. Patients were categorized into a low- (≤ 43 points), intermediate- (44-53 points) and high-risk score groups (≥ 54 points). TTVR led to an improvement of TR (p < 0.0001) and NYHA (p < 0.0001). Kaplan-Meier analysis and log-rank test revealed that higher GWTG-HF scores were associated with reduced rates of event-free survival regarding mortality (96% vs 89% vs 73%, respectively, p = 0.001) and hospitalization for heart failure (HHF) (89% vs 86% vs 74%, respectively, p = 0.026). After adjusting for important variables like renal function, left ventricular ejection fraction and mitral regurgitation, the GWTG-HF score remained an independent predictor of the composite endpoint of HHF or mortality (hazard ratio 1.04 per 1-point increase, p = 0.029). Other remaining predictors were renal function and mitral regurgitation. The GWTG-HF score used as a risk stratification tool of mortality and HHF maintains its prognostic value in a HF population with severe TR undergoing TTVR.
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Kavsur et al. (2021) conducted an observational in Heart failure with severe tricuspid regurgitation (n=181). Get-With-The-Guidelines-Heart-Failure (GWTG-HF) risk score vs. Lower GWTG-HF risk score was evaluated on Composite of hospitalization for heart failure or all-cause mortality at 1 year (HR 1.04, 95% CI 1.004-1.08, p=0.029). A higher GWTG-HF risk score was independently associated with an increased risk of the composite endpoint of heart failure hospitalization or mortality at 1 year (HR 1.04 per 1-point increase).
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