• Rasih SonsözMehmetM, Cemal Ozanalp, Orkun Canbolat, Ilyas Cetin, Gulden Guven, Yeliz Guler, and Yelda Saltan Ozates.
• Pol. Arch. Med. Wewn. 2025 Jan 2.

IntroductionModerate to severe tricuspid regurgitation (TR) in the setting of acute heart failure (AHF) has been found to be associated with worse clinical outcomes. Recently, the TRI-SCORE was developed to predict clinical outcomes after isolated tricuspid surgery.ObjectivesTo determine whether this score could aid in risk stratification of AHF patients with moderate-severe TR.Patients And MethodsA total of 233 hospitalized patients with AHF and moderate-severe TR were included. We calculated the TRI-SCORE for each patient: age ≥70 years, New York Heart Association class ≥III, right-sided heart failure signs, daily furosemide dose ≥125mg, glomerular filtration rate <30 mL/min, elevated total bilirubin concentrations, left ventricular ejection fraction <60%, and moderate/severe right ventricular dysfunction. The primary endpoint was all-cause mortality during follow-up.ResultsThe median age was 74 (65; 84) years, 129 (55.4%) were female. During a follow-up of 8 (2; 21) months, 135 (57.9%) patients reached the primary endpoint. Patients with the primary endpoint had a higher TRI-SCORE than those without (8 (6; 9) vs. 6 (4; 7); P <0.001). Multivariable Cox regression analysis showed that a one-point increase in the TRI-SCORE was a significant indicator of all-cause mortality (HR: 1.25; %95 CI:1.14-1.38), P <0.001). Kaplan-Meier analysis showed early divergence of low (0-3), intermediate (4-5) and high (³6) TRI-SCORE curves (log rank P <0.001).ConclusionsAHF patients with moderate to severe TR have a poor prognosis during follow-up. TRI-SCORE can predict all-cause mortality in these patients.

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