Clinical Research in Cardiology最新文献

{"title":"QTc interval prolongation as a marker of disease stage in transthyretin cardiac amyloidosis.","authors":"Theodoros Tsampras, Alexios S Antonopoulos, Freideriki-Eleni Kourti, Konstantinos Tsioufis, Charalambos Vlachopoulos","doi":"10.1007/s00392-025-02680-x","DOIUrl":"https://doi.org/10.1007/s00392-025-02680-x","url":null,"abstract":"<p><p>Transthyretin amyloidosis is a significant cause of heart failure with an unfavorable prognosis. In recent years, diagnosing the disease has become easier, with most patients now diagnosed non-invasively, and tissue biopsy being required only in a minority of cases. Although various laboratory findings have been reported as transthyretin amyloidosis red flags, the diagnostic and prognostic value of various electrocardiogram parameters remain largely unknown. In this study, the significance of QTc interval prolongation in transthyretin cardiac amyloidosis patients was investigated. We retrospectively analyzed electrocardiogram data from n = 58 patients with transthyretin amyloid cardiomyopathy and compared them with distinct cohorts of patients diagnosed with other forms of heart muscle disease, i.e., hypertrophic cardiomyopathy and dilated cardiomyopathy. QTc prolongation was found to be a unique feature of transthyretin cardiac amyloidosis, not shared by other cardiomyopathy types. Increased QTc interval in transthyretin amyloidosis patients correlates with disease severity markers, including NYHA class, NAC stage, NT-proBNP, and troponin I levels, suggesting its potential as a unique biomarker for monitoring disease progression.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraprocedural 3D-vena contracta area predicts survival after transcatheter edge-to-edge repair: results from MITRA-PRO registry.","authors":"Dennis Rottländer, Jörg Hausleiter, Thomas Schmitz, Alexander Bufe, Melchior Seyfarth, Ralph Stephan von Bardeleben, Harald Beucher, Taoufik Ouarrak, Steffen Schneider, Peter Boekstegers","doi":"10.1007/s00392-024-02580-6","DOIUrl":"10.1007/s00392-024-02580-6","url":null,"abstract":"<p><strong>Background: </strong>The MITRA-PRO registry revealed residual mitral regurgitation (MR) to be an important predictor of survival following transcatheter edge-to-edge repair (TEER). Intraprocedural MR assessment using 3D-Vena Contracta Area (VCA) might be a feasible tool to guide mitral TEER procedures. The study aimed to assess the impact of residual MR assessed by 3D-VCA on 1-year mortality.</p><p><strong>Methods: </strong>823 patients with residual MR quantification using 3D-VCA in the MITRA-PRO registry, were included in this study. 1-year mortality, NYHA classification and major adverse events were assessed 1-year after mitral TEER.</p><p><strong>Results: </strong>Patients with trace residual MR after mitral TEER were allocated to the 3D-VCA < 0.1 cm² group (27.8%), while a 3D-VCA ≥ 0.1 < 0.3 cm² (55.4%) was considered as mild and a 3D-VCA ≥ 0.3 cm² (16.8%) as relevant residual MR. One-year mortality was significantly lower in patients with non-relevant residual MR (3D-VCA < 0.1 cm²: 10.5%; ≥ 0.1 < 0.3 cm²: 16.0%; ≥ 0.3: 24.8%, p = 0.003). An increasing 3D-VCA post mitral TEER was associated with a higher 1-year mortality. At a 3D-VCA of 0.07 cm² mortality increased significantly (1-year mortality 3D-VCA post mitral TEER ≥ 0.07 cm²: 16.5% vs. < 0.07 cm²: 7.8%; p = 0.005) indicating a 3D-VCA of 0.07 cm² to be a cut-off value for survival in daily practice.</p><p><strong>Conclusions: </strong>Residual MR assessed by 3D-VCA after TEER is associated with 1-year mortality. Therefore, 3D-VCA is a valuable echocardiographic tool for intraprocedural MR assessment during mitral TEER and achieving a lower 3D-VCA improve patient survival. (German Clinical Trials Register: DRKS00012288).</p><p><strong>Trial registration number: </strong>DRKS00012288.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"867-877"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression of tricuspid regurgitation in patients with right ventricular pacing.","authors":"Felix Rudolph, Maria Ivannikova, Johanna Bormann, Arseniy Goncharov, Vanessa Sciacca, Johannes Kirchner, Kai P Friedrichs, Tanja K Rudolph, Thomas Fink, Thomas Eitz, Philipp Sommer, Volker Rudolph, Muhammed Gerçek, Christian Sohns","doi":"10.1007/s00392-025-02684-7","DOIUrl":"10.1007/s00392-025-02684-7","url":null,"abstract":"<p><strong>Objective: </strong>To compare the prevalence and progression of tricuspid regurgitation (TR) after the implantation of right-ventricular pacing cardiac implantable electronic devices (CIEDs) versus biventricular pacing devices.</p><p><strong>Background: </strong>TR in patients with CIEDs is often linked to mechanical interference from leads, but studies show TR can also progress with leadless pacemakers, suggesting a direct effect of pacing.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 549 patients who received a pacemaker (PM), implantable cardioverter defibrillator (ICD), or cardiac resynchronization therapy (CRT) device. Follow-ups were conducted after one year and at least three years with aggregate interrogation and transthoracic echocardiography performed. Patients were categorized into two groups: right-ventricular (RV_all) pacing and biventricular (BiV) pacing.</p><p><strong>Results: </strong>Median age was 68 [57-76] years, with 419 (76.3%) being male. Of these patients, 21.5% received an ICD, 30.4% a PM, and 48.1% a CRT device (RV_all: n = 285; BiV: n = 264). BiV patients had worse left ventricular (LV) function and more pronounced evidence of RV dilatation at baseline. After three years, a relevant TR was more prevalent in the RV paced patients (RV_all: 17.4%; BiV: 9.8%). Also, an increase in TR grade of ≥I° and ≥II° was more frequent in the RV_all group. While tricuspid annular systolic excursion (TAPSE) deteriorated in the RV_all group, it was preserved in the BiV group.</p><p><strong>Conclusions: </strong>RV pacing was associated with a higher prevalence and severity of TR after CIED implantation compared to BiV pacing, but this effect might also be explained by significant differences in the group's clinical characteristics.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"927-938"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of heart failure severity on the mortality benefit of mitral transcatheter edge-to-edge valve repair.","authors":"Valeria Magni, Marianna Adamo, Elisa Pezzola, Antonio Popolo Rubbio, Cristina Giannini, Giulia Masiero, Carmelo Grasso, Paolo Denti, Arturo Giordano, Federico De Marco, Antonio L Bartorelli, Matteo Montorfano, Cosmo Godino, Cesare Baldi, Francesco De Felice, Annalisa Mongiardo, Ida Monteforte, Emmanuel Villa, Gabriele Crimi, Maurizio Tusa, Luca Testa, Lisa Serafini, Dario Cani, Giacinta Guarini, Alda Huqi, Marco Sesana, Marco De Carlo, Francesco Maisano, Giuseppe Tarantini, Corrado Tamburino, Francesco Bedogni, Marco Metra","doi":"10.1007/s00392-024-02490-7","DOIUrl":"10.1007/s00392-024-02490-7","url":null,"abstract":"<p><strong>Background: </strong>To assess the interaction between heart failure (HF) severity and optimal reduction of secondary mitral regurgitation (SMR) on mortality in patients undergoing transcatheter edge-to-edge repair (M-TEER).</p><p><strong>Methods and results: </strong>Among 1656 patients included in the Italian Society of Interventional Cardiology (GIse) registry Of Transcatheter treatment of mitral valve regurgitaTiOn (GIOTTO) 984 had SMR and complete data on advanced HF. Advanced HF was defined as NYHA class III or IV, left ventricular ejection fraction ≤ 30%, and > 1 HF hospitalization during the last 12 months. Optimal M-TEER was defined as residual SMR ≤ 1 + at discharge. One hundred sixteen patients (11.8%) had advanced HF. Achievement of an optimal SMR reduction was similar in patients with and without advanced HF (65% and 60% respectively). Advanced HF was an independent predictor of 2-year all-cause death (adjusted HR 1.52, 95% CI 1.09-2.10). Optimal M-TEER, as compared to a no-optimal M-TEER, was associated with a reduced risk of death both in patients with advanced (HR 0.55, 95% CI 0.32-0.97; p = 0.039) and no-advanced HF (HR 0.59, 95% CI 0.46-0.78; p < 0.001; p = 0.778 for interaction).</p><p><strong>Conclusions: </strong>Advanced HF is associated with poor outcome in patients undergoing M-TEER. However, an optimal SMR reduction reduces the risk of 2-year mortality regardless of HF severity.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"836-845"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the editor: \"cardiovascular magnetic resonance reveals myocardial involvement in patients with active stage of inflammatory bowel disease\" (CRCD-D-24-01694).","authors":"Maximilian Fenski, Jeanette Schulz-Menger","doi":"10.1007/s00392-025-02600-z","DOIUrl":"10.1007/s00392-025-02600-z","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"942"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac implantable electronic device carriers undergoing transcatheter tricuspid valve annuloplasty: real-world insights.","authors":"Jan M Wrobel, Johannes Kirchner, Kai Friedrichs, Thorsten Gietzen, Jan Althoff, Caroline Hasse, Philipp von Stein, Jonas Wörmann, Jennifer von Stein, Jonathan Curio, Felix Rudolph, Maria Ivannikova, Christos Iliadis, Daniel Steven, Stephan Baldus, Volker Rudolph, Roman Pfister, Muhammed Gerçek, Maria I Koerber","doi":"10.1007/s00392-025-02616-5","DOIUrl":"10.1007/s00392-025-02616-5","url":null,"abstract":"<p><strong>Background: </strong>Transtricuspid cardiac implantable electronic devices (CIEDs) complicate the management of tricuspid regurgitation (TR). Transcatheter tricuspid valve annuloplasty (TTVA) offers a promising approach due to minimal interaction with leaflets and transvalvular CIEDs, though real-world evidence is limited.</p><p><strong>Methods: </strong>This bi-center, retrospective study includes 204 consecutive patients who underwent TTVA with the Cardioband (Edwards Lifesciences) for severe symptomatic TR. Patients were divided into CIED carriers and non-CIED carriers. CIED carriers were further classified into those with lead-associated TR (LTR-A) and those with TR unrelated to CIED leads (LTR-B).</p><p><strong>Results: </strong>Among the 204 patients, 41 (20%) were CIED carriers. Of these, 24% had mixed TR etiology (functional and LTR-A), while 76% had predominantly functional TR (LTR-B). Compared to non-CIED-carriers, CIED carriers were more symptomatic (NYHA-FC > II; 93% vs. 89%; p = 0.026) with comparable TR severity at baseline. Intraprocedural success according to the Tricuspid Valve Academic Research Consortium was 68% in CIED carriers and 70% in non-CIED carriers (p = 0.851). LTR-A was associated with poorer TR reduction immediately after TTVA (p = 0.022). Overall safety was comparable, with right ventricular lead dislodgement occurring in one patient. Beyond that, CIED function remained unimpaired. At 30 days, echocardiographic follow-up showed comparable TR reduction (TR ≤ II: 56% vs. 68%; p = 0.219) and NYHA-FU ≤ II (63% vs. 70%; p = 0.524) in CIED-and non-CIED carriers, respectively.</p><p><strong>Conclusions: </strong>TTVA achieves significant TR reduction, providing a safe and effective therapeutic option for TR treatment in CIED carriers. WHAT IS KNOWN?: TTVA using the Cardioband has been approved for severe, symptomatic TR patients, however data on the safety and efficacy in CIED carriers is lacking. WHAT THE STUDY ADDS?: Intraprocedural success and safety were comparable in CIED and non-CIED carriers treated with TTVA. Subgroup analyses showed a trend towards worse outcome and efficiency of TTVA in patients with LTR-A. Postinterventional CIED interrogations did not show critical technical issues.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"878-891"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of GDMT on outcomes after mitral valve edge-to-edge repair stratified by SMR proportionality.","authors":"Lukas Stolz, Daniel Kalbacher, Benedikt Koell, Nicole Karam, Tania Puscas, Marco Metra, Marianna Adamo, Maximilian Spieker, Patrick Horn, Holger Thiele, Tobias Kister, Ralph-Stephan von Bardeleben, Philipp Lurz, Karl-Patrik Kresoja, Christos Iliadis, Roman Pfister, Mohammad Kassar, Fabien Praz, Bruno Melica, Teresa Trenkwalder, Erion Xhepa, Michael Neuss, Christian Butter, Paul Grayburn, Jörg Hausleiter","doi":"10.1007/s00392-025-02599-3","DOIUrl":"10.1007/s00392-025-02599-3","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"939-941"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of a smaller spacer in the PASCAL Ace on residual mitral valve orifice area.","authors":"Michael Paukovitsch, Dominik Felbel, Marijana Tadic, Mirjam Keßler, Jinny Scheffler, Matthias Gröger, Sinisa Markovic, Wolfgang Rottbauer, Leonhard Moritz Schneider","doi":"10.1007/s00392-023-02368-0","DOIUrl":"10.1007/s00392-023-02368-0","url":null,"abstract":"<p><strong>Background: </strong>Mitral transcatheter edge-to-edge repair (M-TEER) is an established treatment for functional mitral regurgitation (FMR) associated with a risk of creating iatrogenic stenosis.</p><p><strong>Objectives: </strong>To investigate the impact of the P10 and its larger spacer compared to the narrower Ace and its smaller spacer on reduction of mitral valve orifice area (MVOA) during M-TEER.</p><p><strong>Methods: </strong>Consecutive patients undergoing M-TEER for treatment of severe FMR were screened retrospectively. Patients with a single PASCAL device implantation within the central segments of the MV leaflets, non-complex anatomy, and baseline MVOA ≥ 3.5cm² were selected. Intraprocedural transesophageal echocardiography was used to compare MVOA reduction with 3D multiplanar reconstruction and direct planimetry. Device selection did not follow a prespecified MVOA threshold.</p><p><strong>Results: </strong>Seventy-two patients (81.0 years, IQR {74.3-85.0}) were included. In 32 patients, the P10 was implanted (44.4%). MR severity (p = 0.66), MR reduction (p = 0.73), and body surface area (p = 0.56) were comparable. Baseline MVOA tended to be smaller in P10 patients with the larger spacer (5.0 ± 1.1 vs. 5.4 ± 1.3cm², p = 0.18), however, residual MVOA was larger in these patients (2.7 ± 0.7 vs. 2.3 ± 0.6cm², p = 0.03). Accordingly, relative MVOA reduction was significantly less in P10 patients (- 45.9 ± 7.6 vs. - 56.3 ± 7.0%, p < 0.01). Indirect annuloplasty was more pronounced in Ace patients whereas mean transmitral gradients were similar.</p><p><strong>Conclusion: </strong>In FMR patients with non-complex anatomy, the larger spacer of the P10 maintains greater MVOA with similar MR reduction. Hence, the use of the PASCAL Ace device in patients with small MVOAs might correlate with a risk of both clinically relevant orifice reduction and even iatrogenic stenosis.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"809-817"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139544940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty, periinterventional complications and outcome in patients undergoing percutaneous mitral and tricuspid valve repair.","authors":"Matthieu Schäfer, Hannah Nöth, Clemens Metze, Christos Iliadis, Maria Isabel Körber, Marcel Halbach, Stephan Baldus, Roman Pfister","doi":"10.1007/s00392-024-02397-3","DOIUrl":"10.1007/s00392-024-02397-3","url":null,"abstract":"<p><strong>Background: </strong>Frailty is common in elderly and multimorbid patients and associated with increased vulnerability to stressors.</p><p><strong>Methods: </strong>In a single centre study frailty according to Fried criteria was assessed in consecutive patients before transcatheter mitral and tricuspid valve repair. Postprocedural infections, blood transfusion and bleeding and renal failure were retrospectively assessed from records. Median follow-up time for survival was 560 days (IQR: 363 to 730 days).</p><p><strong>Results: </strong>90% of 626 patients underwent mitral valve repair, 5% tricuspid valve repair, and 5% simultaneous mitral and tricuspid valve repair. 47% were classified as frail. Frailty was associated with a significantly increased frequency of bleeding (16 vs 10%; p = 0.016), blood transfusions (9 vs 3%; p =  < 0.001) and infections (18 vs 10%; p = 0.006), but not with acute kidney injury (20 vs 20%; p = 1.00). Bleeding and infections were associated with longer hospital stays, with a more pronounced effect in frail patients (interaction test p < 0.05, additional 3.2 and 4.1 days in frail patients, respectively). Adjustment for the occurrence of complications did not attenuate the increased risk of mortality associated with frailty (HR 2.24 [95% CI 1.62-3.10]; p < 0.001).</p><p><strong>Conclusions: </strong>Bleeding complications and infections were more frequent in frail patients undergoing transcatheter mitral and tricuspid valve repair and partly explained the longer hospital stay. Albeit some of the complications were associated with higher long-term mortality, this did not explain the strong association between frailty and mortality. Further research is warranted to explore interventions targeting periprocedural complications to improve outcomes in this vulnerable population.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"827-835"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139734593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Favorable safety profile of NOAC therapy in patients after tricuspid transcatheter edge-to-edge repair.","authors":"Isabel A Hoerbrand, Martin J Kraus, Martin Gruber, Nicolas A Geis, Philipp Schlegel, Norbert Frey, Mathias H Konstandin","doi":"10.1007/s00392-024-02517-z","DOIUrl":"10.1007/s00392-024-02517-z","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter edge-to-edge repair for severe tricuspid regurgitation (TR) is a new treatment option (t-TEER). Data on optimal antithrombotic therapy after t-TEER in patients with an indication for anticoagulation are scarce and evidence-based guideline recommendations are lacking. We sought to investigate efficacy and safety of novel oral anticoagulation (NOAC) and vitamin-K-antagonists (VKA) in patients undergoing t-TEER.</p><p><strong>Methods: </strong>Among 78 consecutive patients with t-TEER of severe TR, 69 patients were identified with concomitant indication for oral anticoagulation. Outcomes of these patients treated with NOAC or VKA were compared over a median follow-up period of 327 (177-460) days.</p><p><strong>Results: </strong>Despite elevated thromboembolic and bleeding risk scores (CHA₂DS₂-VASc 4.2 ± 1.1, HEMORR₂HAGES 3.0 ± 1.0 and HAS-BLED 2.1 ± 0.8), only one major bleeding incidence occurred under NOAC therapy. The risk for overall (NOAC 8% vs. VKA group 26%, p = 0.044) and major bleeding events (NOAC 2% vs. VKA 21%, p = 0.010) was significantly lower in the NOAC compared to the VKA group. No significant difference was found between NOAC and VKA treatment in terms of mortality (NOAC 18% vs. VKA 16%, p = 0.865) or the combined endpoint of death, heart failure hospitalization, stroke, embolism, thrombosis, myocardial infarction, and severe bleeding (NOAC 48% vs. VKA 42%, p = 0.801). A comparison between apixaban (n = 27) and rivaroxaban (n = 16) treated patients revealed no significant differences between NOAC substances (all bleeding events apixaban 7% vs. rivaroxaban 13%, p = 0.638).</p><p><strong>Conclusion: </strong>Results of this study indicate that NOACs may offer a favorable risk-benefit profile for patients with concomitant indication for anticoagulation therapy following t-TEER.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"846-855"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}