Mavacamten use in obstructive hypertrophic cardiomyopathy was associated with a higher risk of adverse outcomes in patients with preexisting atrial fibrillation, and Black patients had lower access.
Observational
Yes
Does mavacamten affect clinical outcomes in patients with obstructive hypertrophic cardiomyopathy?
Real-world data reveals racial disparities in mavacamten access and highlights that preexisting atrial fibrillation increases the risk of adverse outcomes in treated patients.
BACKGROUND: Mavacamten improves symptoms in obstructive hypertrophic cardiomyopathy, but real-world prescription patterns, safety profile, and the effect of atrial fibrillation (AF) on outcomes remain unclear. METHODS: An observational multicenter analysis using patient-level data from the TriNetX database (2011-2023) compared patients with obstructive hypertrophic cardiomyopathy treated with mavacamten versus those not treated with mavacamten (controls). Multivariable logistic regression identified predictors of mavacamten use. Propensity-score matching was used to reduce confounding bias. Outcomes included acute heart failure, left ventricular systolic dysfunction, cardiovascular hospitalization, new-onset AF, and all-cause mortality. Outcomes were also stratified by AF history. RESULTS: <0.01). Older age independently predicted acute heart failure, whereas baseline AF predicted both cardiovascular and all-cause hospitalization. CONCLUSIONS: Black patients have markedly lower access to mavacamten. Preexisting AF was associated with a higher risk of adverse outcomes for patients on mavacamten, highlighting the need for careful monitoring.
Fath et al. (Mon,) conducted a observational in Obstructive hypertrophic cardiomyopathy. Mavacamten vs. No mavacamten (controls) was evaluated on Acute heart failure, left ventricular systolic dysfunction, cardiovascular hospitalization, new-onset AF, and all-cause mortality. Mavacamten use in obstructive hypertrophic cardiomyopathy was associated with a higher risk of adverse outcomes in patients with preexisting atrial fibrillation, and Black patients had lower access.