Next-generation biomarkers for short term risk stratification in tricuspid valve intervention

Background Interventional therapies for tricuspid regurgitation are rapidly evolving, yet optimal patient selection remains challenging. Conventional biomarkers such as NT-proBNP may inadequately reflect the complex pathophysiology and clinical risk in this population. Emerging biomarkers—including soluble suppression of tumorigenicity 2 (sST2), soluble urokinase-type plasminogen activator receptor (suPAR), heart-type fatty acid-binding protein (H-FABP), and growth differentiation factor-15 (GDF-15)—remain insufficiently studied in patients undergoing transcatheter tricuspid valve interventions.Methods This prospective, single-center observational cohort study enrolled consecutive patients undergoing transcatheter treatment for severe tricuspid regurgitation, including transcatheter edge-to-edge repair and heterotopic caval valve implantation. Pre-procedural blood samples were collected and analyzed for GDF-15, suPAR, H-FABP, and sST2 using standardized assays. Prognostic performance for the composite endpoint of all-cause mortality or heart-failure rehospitalization within three months was assessed using receiver-operating-characteristic analysis and multivariable Cox regression.Results Sixty patients (mean age 80.3 ± 7.3 years; 48.3% male) were included. At three months, 12 patients (20%) were rehospitalized and 6 (10%) had died. GDF-15 (AUC 0.867) and suPAR (AUC 0.885) demonstrated strong predictive accuracy and outperformed NT-proBNP. GDF-15 >1,400 pg/mL independently predicted adverse outcomes (HR 2.03, p = 0.046).Conclusion GDF-15 and suPAR provide incremental prognostic value for short-term risk stratification after transcatheter tricuspid valve intervention.