OBJECTIVES: Tricuspid regurgitation (TR) is the most common lesion of the tricuspid valve. Moderate or severe TR can lead to irreversible myocardial damage and adverse outcomes. Typically, surgeries are required for clinically significant TR. This study aimed to quantify the healthcare burden of clinically significant TR in patients with and without heart failure (HF).

METHODS: Taiwan’s National Health Insurance Research Database from Jan 2017 to Dec 2019 were used. Patients over the age of 18 with medical record 12 months pre (baseline) and 6 months post (landmark) the first TR diagnosis were enrolled in this study. Cohorts were divided into 3 groups: (1) No HF; (2) HF (3) Inconclusive HF, each with subgroups: with or without clinical significance. Clinical significance was defined as a record of pulmonary hypertension with ascites, lower extremity edema or hepatic insufficiency, or tricuspid valve surgery during the landmark period. Outcomes studied included All-cause hospitalizations, hospital days, and expenditures.

Results: 21,051 TR patients were identified and 3.88% (N=816) of TR patients had a HF diagnosis in the baseline period. Comparing the clinically significant. TR patients to those with or without HF, clinically significant TR patients with HF had statistically higher rates of underlying disease like pulmonary circulation disorders (23.23% v.s. 15.28%), hypothyroidism (6.45% v.s. 2.57%) and liver disease (21.94% v.s. 6.05%). Clinically significant TR patients with HF also demonstrated increased healthcare utilization and expenditures significantly. For these patients, the annualized economic burden increased by 9% to 2.92 all-cause hospitalizations, by 30% to 34.52 for hospitalization days, and 74% to USD 17,047 for annualized healthcare costs as compared to non-clinically significant TR with HF patients.

Conclusions: The presence of clinically significant TR with HF is associated with an increased risk of hospitalization, healthcare resource utilization and financial burden.