Impact of Tricuspid Regurgitation on the Clinical Outcomes of Patients with Heart Failure.

Background: Tricuspid regurgitation (TR) is a common occurrence in patients with heart failure (HF), and its role in disease progression has gained attention in recent years. Although TR can worsen clinical outcomes in HF patients, the impact of gender, racial, and socioeconomic factors remains largely unexplored. With growing evidence supporting the role of percutaneous interventions for the treatment of significant TR, understanding these disparities is more crucial than ever.

Methods: Data were extracted from the National Inpatient and National Readmission 2016-2020 Databases. We used ICD-10 code I50 to identify the patients primarily admitted for HF and subdivided the cohort into two groups based on the presence or absence of TR. We performed multivariable logistic regression analysis to determine odds of the in-hospital mortality and multivariable Cox regression analysis to assess the 30- and 90-day hospital readmission in HF patients with and without TR. All the analyses were adjusted for age, gender, insurance status, Charlson comorbidity index, and hospital characteristics. STATA 16 software was used for analysis.

Results: There was no difference in the in-hospital mortality among HF patients with and without TR (OR: 1.04, 95% CI 0.94-1.16, p = 0.442) except in certain subgroups of HF patients. HF patients with TR were 6% more likely to have HF-specific readmission in 30 days (HR: 1.06, 95% CI 1.00-1.13, p = 0.044) and 9% more likely to have HF-specific readmission in 90 days (HR: 1.09, 95% CI 1.03-1.15, p = 0.002). Subgroup analysis revealed significant gender, racial, and socioeconomic disparities in the in-hospital mortality and the readmission outcomes of HF patients with TR compared to those without TR.

Conclusion: In our population-based survey analysis, we observed significant gender, racial, and socioeconomic disparities in the clinical outcomes of HF patients with TR compared to those without TR.