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Management and Outcome of Patients Admitted with Tricuspid Regurgitation in France

Abstract : BACKGROUND: Growing evidence shows a major outcome impact and under-treatment of tricuspid regurgitation (TR) but large and comprehensive contemporary reports of management and outcome at the nationwide level are lacking. METHODS: We gathered all consecutive patients admitted with a diagnosis of likely functional TR in 2014-2015 in France from the "Programme de Médicalisation des Systèmes d'Information" (PMSI) national database and collected rate of surgery, in-hospital mortality, one-year mortality or heart failure (HF) readmission rates. RESULTS: In 2014-2015, 17,676 consecutive patients (75±14 years, 51% female) were admitted with a TR diagnosis. Charlson index was ≥2 in 56% of the population and 46% presented with heart failure. TR was associated with prior cardiac surgery, ischemic/dilated cardiomyopathy or mitral regurgitation in 73% of patients. Only 10% of TR patients overall and 67% of those undergoing a mitral valve surgery received a tricuspid valve intervention. Among the 13,654(77%) conservatively managed patients, in-hospital mortality, one-year mortality and one-year mortality or HF readmission rates were 5.1%,17.8% and 41% respectively overall and 5.3%,17.2% and 37% respectively in those no underlying medical conditions (8-times higher than predicted for age and gender). CONCLUSION: This nationwide cohort of patients admitted with TR included elderly patients with frequent comorbidities/underlying cardiac diseases. In patients conservatively managed, mortality and morbidity were considerably high over a short time-span. Despite this poor prognosis only 10% of patients underwent a tricuspid valve intervention. These nationwide data showing a considerable risk and potential underuse of treatment highlight the critical need to develop strategies to improve the management and outcomes of TR patients.
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Submitted on : Wednesday, June 23, 2021 - 4:35:16 PM
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D. Messika-Zeitoun, P. Candolfi, J. Dreyfus, I. G. Burwash, B. Iung, et al.. Management and Outcome of Patients Admitted with Tricuspid Regurgitation in France. Canadian Journal of Cardiology, Elsevier, 2020, pp.S0828-282X(20)31178-8. ⟨10.1016/j.cjca.2020.12.012⟩. ⟨inserm-03269074⟩



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