Comorbidities, including obesity, were not independently associated with new-onset atrial fibrillation or sudden cardiac death in patients with hypertrophic cardiomyopathy (p>0.10 for each).
Cohort (n=2,269)
No
Does the presence of comorbidities increase the risk of new-onset atrial fibrillation and sudden cardiac death in patients with hypertrophic cardiomyopathy?
In adult patients with hypertrophic cardiomyopathy, adverse events such as atrial fibrillation and sudden cardiac death appear to be driven primarily by underlying myopathy rather than comorbid conditions.
p-value: p=>0.10
Abstract Background The impact of comorbid disease states on the development of atrial and ventricular arrhythmias in patients with hypertrophic cardiomyopathy (HCM) remains unresolved. Objective Evaluate the association of comorbidities linked to arrhythmias in other cardiovascular diseases (e.g., obesity, systemic hypertension, diabetes, obstructive sleep apnea, renal disorders, tobacco, and alcohol use) to atrial fibrillation (AF) and sudden cardiac death (SCD) events in a large cohort of HCM patients. Methods A total of 2269 patients, 54 ± 15 years of age, 1392 males, were evaluated at the Tufts HCM Institute between 2004 and 2018 and followed for an average of 4 ± 3 years for new‐onset clinical AF and SCD events (appropriate defibrillation for ventricular tachyarrhythmias, resuscitated cardiac arrest, or SCD). Results One or more comorbidity was present in 75% of HCM patients, including 50% with ≥2 comorbidities, most commonly obesity (body mass index BMI ≥ 30 kg/m 2 ) in 43%. New‐onset atrial fibrillation developed in 11% of our cohort (2.6%/year). On univariate analysis, obesity was associated with a 1.7‐fold increased risk for AF ( p = .03) with 12% of obese patients developing AF (3.3%/year) as compared to 7% of patients with BMI .10 for each). SCD events occurred in 3.3% of patients (0.8%/year) and neither obesity nor other comorbidities were associated with increased risk for SCD ( p > .10 for each). Conclusions In adult HCM patients comorbidities do not appear to impact AF or SCD risk. Therefore, for most patients with HCM, adverse disease related events of AF and SCD appear to be primarily driven by underlying left ventricular and atrial myopathy as opposed to comorbidities.
Sridharan et al. (Tue,) conducted a cohort in Hypertrophic cardiomyopathy (n=2,269). Comorbidities (e.g., obesity, hypertension, diabetes) vs. Absence of comorbidities was evaluated on New-onset clinical atrial fibrillation and sudden cardiac death events (p=>0.10). Comorbidities, including obesity, were not independently associated with new-onset atrial fibrillation or sudden cardiac death in patients with hypertrophic cardiomyopathy (p>0.10 for each).
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