Transcatheter therapies for the treatment of tricuspid regurgitation (TR) have grown “exponentially” in Germany over the past decade, a research letter published in JACC: Cardiovascular Interventions has detailed, reflecting “very rapid” adoption of these techniques in clinical practice.
Using data from the DRG-Statistic database of the German Federal Statistic Office, Jakob Christoph Voran and colleagues at University Hospital Schleswig-Holstein (Kiel, Germany) assessed trends in the use of catheter-based therapies for the treatment of TR, including transcatheter edge-to-edge-repair (TEER), from 2012 to 2023.
They were able to show that cases increased from a total of 74 in the four years from 2012 to 2015, to 4,298 in 2023—with 13,165 cases with endovascular intervention for TR recorded over the entire 11-year period.
“This first comprehensive real-world data analysis of percutaneous tricuspid valve treatment in Germany showed an exponential increase in procedure numbers,” Voran and colleagues write. “This striking finding proves a very rapid adoption of this novel transcatheter concept.”
The researchers compared the real-world data to findings from randomised trials including TRILUMINATE pivotal, TRI.FR and TRISCEND II, finding that patients were typically older outside of the clinical trial setting, with a median age of 81 years, and had a longer median length of hospital stay in real-world practice, at eight days, compared to a median of 1–3 days within the trials. In-hospital mortality declined from more than 4% in 2016 to 1.6% in 2023.
Though the researchers were unable to consistently compare real-world outcomes for each comorbidity with those reported in the trials, they did show that the presence of chronic kidney disease was reported more frequently than in TRILUMINATE, but was comparable with the rates reported in TRISCEND II, and diabetes was reported meaningfully more frequently than in TRILUMINATE and TRI.FR.
“Caution is warranted, as the number of patients in randomised controlled clinical trials was small, and trials were positive only for improved quality of life, with a potential placebo effect still being discussed,” the investigators write.
