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
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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.