Abstract 4148117: Efficacy of TRISCORE in predicting the long-term survival in patients undergoing transcatheter tricuspid valve replacement or surgical tricuspid valve replacement: a systematic review and meta-analysis

Background: Tricuspid regurgitation (TR) is a prevalent disease in the population and is usually progressive. Most patients are treated with conservative management due to the risk involving transcatheter tricuspid valve replacement (TTVR) and surgical tricuspid valve replacement (STVR). The TRI-SCORE was developed to evaluate the severity of patients with TR and their risk of undergoing a correction procedure. However, there is still controversy regarding the cutoff value of the score. Therefore, we aim to perform a systematic review and meta-analysis comparing the cutoffs ≥6 with <6 of the TRI-SCORE in patients with TR undergoing TTVR or STVR. Methods: We systematically searched Embase, Pubmed, and Cochrane for randomized controlled trials (RCT) and observational studies comparing cutoffs of >=6 with <6 of the TRI-SCORE in patients with TR undergoing STVR or TTVR. We focused on the primary outcomes of (1) all-cause mortality. A prespecified subgroup analysis was performed comparing STVR with TTVR. Odds Rartion(ORs) with 95% confidence interval (CI) were pooled across studies using a random effect model. Results: We included three studies encompassing 2063 patients, of whom 441 had a cutoff ≥6 (42.12%) at the TRISCORE.. The mean follow-up was 2.5 years). In the pooled analysis, our results show all-cause mortality significant decrease at the cutoff of <6 in TRISCORE, with lower mortality events (OR 1.15; 95%CI 1.06-2.26; p<0.01; Fig.1). The subgroup analysis revealed a significant subgroup difference between STVR and TTVR for the outcome of all-cause mortality (p<0.01) favoring the STVR group (OR 2.13; 95%CI 1.51 - 3.01;p<0.01; Fig.1). Conclusion: In our meta-analysis of patients with TR undergoing TTVR or STVR, a cutoff ≥ 6 at the TRISCORE was associated with a worse prognosis, with significantly higher rates of all-cause mortality and 30-day mortality. The subgroup analysis demonstrated a higher benefit in =TTVR subgroup