Healthcare utilization in clinically significant tricuspid regurgitation patients with and without heart failure
Publication: Journal of Comparative Effectiveness Research
Abstract
Aim: This study evaluated how the presence of right-sided heart disease (RSHD), other valve disease (OVD) and heart failure (HF) impacts healthcare utilization in patients with tricuspid valve disease (tricuspid regurgitation [TR]). Materials & methods: Of the 33,686 patients with TR: 6618 (19.6%) had TR-only; 8952 (26.6%) had TR with HF; 12,367 (36.7%) had TR with OVD but no HF; and 5749 (17.1%) had TR with RSHD only. Results: The presence of RSHD, OVD or HF in patients with TR was independently associated with increased annualized hospitalizations, hospital days and costs relative to patients with TR alone. Conclusion: All three co-morbidities were associated with increased healthcare utilization, with HF showing the greatest impact across all measures.
Formats available
You can view the full content in the following formats:
References
Papers of special note have been highlighted as: •• of considerable interest
1.
Stuge B, Holm I, Vollestad N. To treat or not to treat postpartum pelvic girdle pain with stabilizing exercises? Man. Ther. 11(4), 337–343 (2006).
2.
Benfari G, Antoine C, Miller WL et al. Excess mortality associated with functional ricuspid regurgitation complicating heart failure with reduced ejection fraction. Circulation 140(3), 196–206 (2019).
3.
Nath J, Foster E, Heidenreich PA. Impact of tricuspid regurgitation on long-term survival. J. Am. Coll. Cardiol. 43(3), 405–409 (2004).
4.
Harris C, Croce B, Munkholm-Larsen S. Tricuspid valve disease. Ann. Cardiothorac. Surg. 6(3), 294 (2017).
5.
Agarwal S, Tuzcu EM, Rodriguez ER, Tan CD, Rodriguez LL, Kapadia SR. Interventional cardiology perspective of functional tricuspid regurgitation. Circ. Cardiovasc. Interv. 2(6), 565–573 (2009).
6.
Cork DP, McCullough PA, Mehta HS et al. The economic impact of clinically significant tricuspid regurgitation in a large, administrative claims database. J. Med. Econ. 23(5), 521–528 (2020).
•• Investigated the healthcare burden of tricuspid regurgitation (TR) patients with and without heart failure (HF), concluding that irrespective of the presence of HF, clinically significant TR is associated with an increase in healthcare utilization and expenditures our current study bulids upon this article.
7.
Beckhoff F, Alushi B, Jung C et al. Tricuspid regurgitation – medical management and evolving interventional concepts. Front. Cardiovasc. Med. 5, 49 (2018).
8.
Topilsky Y, Nkomo VT, Vatury O et al. Clinical outcome of isolated tricuspid regurgitation. JACC Cardiovasc. Imaging 7(12), 1185–1194 (2014).
9.
Rodes-Cabau J, Hahn RT, Latib A et al. Transcatheter therapies for treating tricuspid regurgitation. J. Am. Coll. Cardiol. 67(15), 1829–1845 (2016).
10.
Antunes MJ, Barlow JB. Management of tricuspid valve regurgitation. Heart 93(2), 271–276 (2007).
11.
Sadeghpour A, Hassanzadeh M, Kyavar M et al. Impact of severe tricuspid regurgitation on long term survival. Res. Cardiovasc. Med. 2(3), 121–126 (2013).
12.
Lee JW, Song JM, Park JP, Lee JW, Kang DH, Song JK. Long-term prognosis of isolated significant tricuspid regurgitation. Circ. J. 74(2), 375–380 (2010).
13.
Bohbot Y, Chadha G, Delabre J, Landemaine T, Beyls C, Tribouilloy C. Characteristics and prognosis of patients with significant tricuspid regurgitation. Arch. Cardiovasc. Dis. 112(10), 604–614 (2019).
14.
Benjamin EJ, Muntner P, Alonso A et al. Heart Disease and Stroke Statistics-2019 Update: a report from the American Heart Association. Circulation 139(10), e56–e528 (2019).
15.
Nishimura RA, Otto CM, Bonow RO et al. 2014 AHA/ACC Guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation 129(23), 2440–2492 (2014).
16.
Zack CJ, Fender EA, Chandrashekar P et al. National trends and outcomes in isolated tricuspid valve surgery. J. Am. Coll. Cardiol. 70(24), 2953–2960 (2017).
17.
Topilsky Y, Maltais S, Medina Inojosa J et al. Burden of tricuspid regurgitation in patients diagnosed in the community setting. JACC Cardiovasc. Imaging 12(3), 433–442 (2019).
•• This is a recent estimate of TR prevalence at: approximately 0.55% in the USA, which is adjusted for age and sex.
18.
Mutlak D, Lessick J, Khalil S, Yalonetsky S, Agmon Y, Aronson D. Tricuspid regurgitation in acute heart failure: is there any incremental risk? Eur. Heart J. Cardiovasc. Imaging 19(9), 993–1001 (2018).
19.
Hahn RT, Waxman AB, Denti P, Delhaas T. Anatomic relationship of the complex rricuspid valve, Right ventricle, and pulmonary vasculature: a review. JAMA Cardiol. 4(5), 478–487 (2019).
20.
Optum. Optum integrated data (2015). https://www.optum.com/content/dam/optum3/optum/en/resources/fact-sheets/Integrated-Data-product-sheet.pdf
21.
Messika-Zeitoun D, Verta P, Gregson J et al. Impact of tricuspid regurgitation on survival in patients with heart failure: a large electronic health record patient-level database analysis. Eur. J. Heart Fail. (2020) (Epub ahead of print).
•• This is the latest publication that estimates the impact of severe TR on mortality among patients with HF and uses Optum’s data.
22.
Elixhauser A, Steiner C, Harris DR, Coffey RM. Comorbidity measures for use with administrative data. Med. Care 36(1), 8–27 (1998).
Information & Authors
Information
Published In
Pages: 29 - 37
PubMed: 33174767
Copyright
© 2020 Joanna Van Houten et al. This work is licensed under the Attribution-NonCommercial-NoDerivatives 4.0 Unported License
History
Received: 10 September 2020
Accepted: 14 October 2020
Published online: 11 November 2020
Keywords:
Topics
Authors
Funding Information
Metrics & Citations
Metrics
Article Usage
Article usage data only available from February 2023. Historical article usage data, showing the number of article downloads, is available upon request.
Citations
How to Cite
Healthcare utilization in clinically significant tricuspid regurgitation patients with and without heart failure. (2020) Journal of Comparative Effectiveness Research. DOI: 10.2217/cer-2020-0198
Export citation
Select the citation format you wish to export for this article or chapter.
Citing Literature
- Tochukwu R. Nzeako, Chukwuka Elendu, Ali Moradi, Olawale Olanisa, Adekunle Kiladejo, Percutaneous interventions in tricuspid valve disease: a new era in cardiac treatment, Annals of Medicine & Surgery, 10.1097/MS9.0000000000003437, 87, 7, (4262-4280), (2025).
- Mahesh V. Madhavan, Colin M. Barker, Lisa S. Kemp, Sarah Mollenkopf, Michael Ryan, Candace Gunnarsson, David J. Cohen, Real-World Clinical Outcomes and Health Care Utilization in Patients With Severe Tricuspid Regurgitation, Structural Heart, 10.1016/j.shj.2025.100463, 9, 5, (100463), (2025).
- Colin M. Barker, Lisa S. Kemp, Melissa Mancilla, Sarah Mollenkopf, Candace Gunnarsson, Michael Ryan, Guy David, Inequities in Access to Tricuspid Valve Treatments, JACC: Advances, 10.1016/j.jacadv.2024.101342, 3, 11, (101342), (2024).
- Ching-Hu Chung, Healthcare utilization and expenditures in patients with tricuspid regurgitation: A population-based cohort study, IJC Heart & Vasculature, 10.1016/j.ijcha.2024.101495, 54, (101495), (2024).
- Rongyang Xi, Muhammad Ahsan Mumtaz, Dingli Xu, Qingchun Zeng, Tricuspid Regurgitation Complicating Heart Failure: A Novel Clinical Entity, Reviews in Cardiovascular Medicine, 10.31083/j.rcm2509330, 25, 9, (2024).
- Mark A. Lebehn, Rebecca T. Hahn, Valvular Heart Failure due to Tricuspid Regurgitation, Heart Failure Clinics, 10.1016/j.hfc.2023.02.003, 19, 3, (329-343), (2023).
- Colin M. Barker, Kashish Goel, Transcatheter Tricuspid Interventions: Past, Present, and Future, Methodist DeBakey Cardiovascular Journal, 10.14797/mdcvj.1250, 19, 3, (57-66), (2023).