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Research Article
11 December 2025

Racial and ethnic differences in diagnosis, healthcare utilization and 1-year outcomes for patients with significant tricuspid regurgitation

Authors: Frank Medina https://orcid.org/0009-0003-2324-8527, David P Cork https://orcid.org/0009-0005-6541-8736, Rebecca Horn https://orcid.org/0000-0003-0806-6955, Lisa Kemp https://orcid.org/0000-0003-4039-1512, Prakriti Gaba, Alissa Dratch https://orcid.org/0000-0002-2315-979X, Shannon ME Murphy https://orcid.org/0000-0001-7429-9365, Sarah Mollenkopf https://orcid.org/0000-0001-9214-2492, Colin Barker https://orcid.org/0000-0002-7904-0501, and Robert W Yeh https://orcid.org/0000-0002-0564-4468 [email protected]Author Info & Affiliations
Volume 15, Number 1
https://doi.org/10.57264/cer-2025-0156
PDFFormats

Abstract

Background: The impact of race and ethnicity on prognosis and clinical outcomes in patients with significant tricuspid regurgitation (sTR) is not well understood. Aim: Describe healthcare utilization trends preceding the development of sTR and assess clinical outcomes 1-year post-sTR status by race and ethnicity. Materials & methods: We conducted a retrospective, longitudinal descriptive study using data from a large database containing electronic health record and insurance claims information. We employed multivariate modeling to assess the relationship between 1-year clinical outcomes and mutually exclusive race/ethnicity groups and other baseline factors. Results: Black patients were more likely to be identified as having sTR as inpatients when compared with White patients (p < 0.001) and had fewer outpatient visits to cardiac specialists before and after developing sTR (p < 0.01). Black and Hispanic patients with sTR were at increased risk of heart failure hospitalization compared with White patients at 1 year (adjusted HR: 1.21, 95% CI: 1.16–1.26, p < 0.001 and adjusted HR: 1.10, 95% CI: 1.02–1.19, p < 0.05 respectively). However, both Black and Hispanic patients had lower 1-year mortality than White patients in the adjusted model. Conclusion: Black and Hispanic patients are less likely to have received outpatient care by a cardiac specialist prior to the development of sTR, and have higher rates of heart failure hospitalization after diagnosis. In contrast, their mortality rates following sTR identification are lower than White patients. Further investigation into the underlying mechanisms of these observations is needed to improve TR-related outcomes.

Plain language summary

What is this article about?

Tricuspid regurgitation (TR) is a heart valve condition that can progress in terms of symptoms and severity over time. The purpose of this article is to understand if there are differences in healthcare pathways leading up to and clinical outcomes after significant symptoms and severity are present that are related to race and ethnicity.

What methodology was used in this study?

This a retrospective observational study. Researchers identified a group of patients with significant TR (sTR) in a real-world database that has information from medical records and insurance claims and examined their demographic and clinical characteristics as well as 1-year health outcomes.

What were the results?

Race and ethnicity categories were related to the kind of healthcare patients received leading up to a time point when their TR was identified as significant and to how often patients were hospitalized for heart failure or died in the year after. Before sTR, Black and Hispanic patients received more acute care compared with White patients and White patients received more outpatient cardiac specialist care compared with Black and Hispanic patients. After significant TR, Black and Hispanic patients were at increased risk of heart failure hospitalization compared with White patients, while White patients were at increased risk of death compared with Black and Hispanic patients.

Why are these results important?

These results suggest that race and ethnicity may play a role in healthcare experiences and outcomes for people with sTR. The findings highlight differences in care and outcomes, emphasizing the need for healthcare providers and systems to address these differences. Understanding and reducing such differences is important for making sure all patients receive high-quality, equitable care for sTR, ultimately improving health for everyone.

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Supplementary Material

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References

Papers of special note have been highlighted as: • of interest
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