Key result
Baseline severe tricuspid regurgitation independently predicted higher 2-year all-cause mortality compared to moderate or less severity (29.6% vs 19.6%; adjusted HR 2.01; 95% CI 1.35-3.00; P<0.001).
Why the study?
The presence of tricuspid regurgitation may affect prognosis in patients with primary mitral regurgitation, prompting investigation into its impact on outcomes after M-TEER.
Does baseline severe tricuspid regurgitation increase 2-year all-cause mortality in patients with primary mitral regurgitation undergoing successful M-TEER?
Cohort (n=2,155)
Yes
Does baseline severe tricuspid regurgitation increase 2-year all-cause mortality in patients with primary mitral regurgitation undergoing successful M-TEER?
Answers are grounded in this paper and cite their sources.
In patients undergoing successful M-TEER for primary mitral regurgitation, baseline severe tricuspid regurgitation is independently associated with a twofold increased risk of 2-year all-cause mortality.
BACKGROUND: The presence of tricuspid regurgitation (TR) may affect prognosis in patients with primary mitral regurgitation. This study sought to investigate the impact of concomitant TR on clinical outcomes in patients with primary mitral regurgitation undergoing mitral transcatheter edge-to-edge repair (M-TEER). METHODS: The PRIME-MR registry (Outcomes of Patients Treated With Mitral Transcatheter Edge-to-edge Repair for Primary Mitral Regurgitation) included 3083 patients with severe primary mitral regurgitation undergoing M-TEER from 2008 to 2022 at 25 international sites. Only patients with successful M-TEER procedures (mitral regurgitation≤Moderate) were analyzed. The study population was stratified by baseline TR severity: TR≤Moderate (TR≤Mod) versus TR≥Severe (TR≥Sev). The primary end point was 2-year all-cause mortality. RESULTS: A total of 2155 patients were analyzed: TR≥Sev (n=421 [20%]) versus TR≤Mod (n=1734 [80%]). Patients with TR≥Sev were more likely to be New York Heart Association III/IV ( P =0.003), have shorter 6-minute walk distance ( P <0.001), higher NT-proBNP (N-terminal pro-B-type natriuretic peptide; P <0.001), higher creatinine ( P <0.001), higher pulmonary artery pressures ( P <0.001), atrial fibrillation ( P <0.001), and more diuretics ( P <0.001) than those with TR≤Mod. At 2 years, patients with TR≥Sev had higher mortality (29.6% versus 19.6%; P log-rank <0.0001) and heart failure hospitalization (21.1% versus 16.8%; P Gray =0.018) than TR≤Mod. Baseline TR≥Sev was an independent predictor of 2-year mortality (adjusted hazard ratio, 2.01 [95% CI, 1.35–3.00]; P <0.001). Although TR≥Sev decreased in 30% of patients after successful M-TEER, residual TR≥Sev was still associated with higher mortality (30.4% versus 19.9%; P log-rank =0.0037) than TR≤Mod. CONCLUSIONS: In the PRIME-MR registry, 20% of patients with primary mitral regurgitation had severe TR at baseline. TR severity improved in 30% of TR≥Sev patients after successful M-TEER. The presence of TR≥Sev was independently associated with increased all-cause mortality at 2 years.
No takes yet. Share an insight, caveat, or question.
Scotti et al. (2026) conducted a cohort in Primary mitral regurgitation (n=2,155). Baseline tricuspid regurgitation ≥Severe vs. Baseline tricuspid regurgitation ≤Moderate was evaluated on 2-year all-cause mortality (adjusted HR 2.01, 95% CI 1.35-3.00, p=<0.001). Baseline severe tricuspid regurgitation independently predicted higher 2-year all-cause mortality compared to moderate or less severity (29.6% vs 19.6%; adjusted HR 2.01; 95% CI 1.35-3.00; P<0.001).
Synapse has enriched 10 related papers. Consider them for comparative context: