What is the clinical evidence from this study?

Study design: Cohort. Population: Obstructive hypertrophic cardiomyopathy (n=1141). Intervention: Symptomatic disease vs. Asymptomatic disease. Primary outcome: All-cause mortality (incidence per 100 patient-years).

October 27, 2025Open Access

Clinical and economic burden associated with symptomatic and asymptomatic obstructive hypertrophic cardiomyopathy in Germany

FSFarbod Sedaghat‐HamedaniHeart Failure & Transplant CZCarla L. ZemaBristol-Myers Squibb (Germany)MSMichael SchultzeBerlin Center for Epidemiology and Health Research

Key Result

Symptomatic obstructive hypertrophic cardiomyopathy was associated with higher all-cause mortality and greater annual healthcare costs (€5975 vs. €4399) compared to asymptomatic disease.

Study Design

Type

Cohort (n=1,141)

Structured PICO

Population

1,141 adults (aged ≥18 years) with obstructive hypertrophic cardiomyopathy (HCM) in Germany, identified from a national claims database (2012-2018). At baseline, 649 were symptomatic (mean age 62.8, 59% male, mean CCI 2.82) and 492 were asymptomatic (mean age 55.5, 67% male, mean CCI 1.69).

Outcome

Annual prevalence, patient characteristics, health outcomes (all-cause mortality and cardiovascular events), healthcare resource utilization, and costs

In Germany, symptomatic obstructive hypertrophic cardiomyopathy is associated with a significantly greater clinical and economic burden, including higher mortality and healthcare costs, compared to asymptomatic disease.

Main Result

Absolute Event Rate: 0.05% vs 0.02%

Limitations

Based on secondary claims data intended for reimbursement, dependent on coding quality
Did not assess patients with private health insurance
NYHA functional class and symptoms were assigned based on a proxy algorithm, which may lead to misclassification
Exact dates for outpatient diagnoses could not be determined
Some patients changed categories during follow-up, meaning comparisons were not truly independent

Abstract

Abstract Background The clinical and economic burden of obstructive hypertrophic cardiomyopathy (HCM) in Germany for symptomatic versus asymptomatic patients has not been comprehensively assessed. Methods This retrospective observational study analyzed nationally representative WIG2 Benchmark Database data, identifying adults diagnosed with obstructive HCM from 2012 to 2018. Study index was the first date when a participant met eligibility criteria. An algorithm based on coded symptoms and pharmacological treatments was used to divide patients into symptomatic and asymptomatic subgroups. Annual prevalence, patient characteristics, outcomes, resource utilization, and costs were assessed during follow-up. Results Overall, 1141 patients were included (649 symptomatic patients and 492 asymptomatic patients during the 1-year pre-index period baseline). In total, 1042 patients had symptomatic disease at some point during follow-up. Annual obstructive HCM prevalence increased between 2011 and 2019 and was higher for symptomatic than asymptomatic patients. Compared with asymptomatic patients, symptomatic patients: were older (mean age: 62.8 vs. 55.5 years), were less likely to be male (59% vs. 67%), and had higher Charlson Comorbidity Index (mean: 2.82 vs. 1.69) at baseline; had higher rates of all-cause mortality (0.05 vs. 0.02 per 100 patient-years) and cardiovascular events (mean follow-up: 4.7 years); had more outpatient visits (13.3 vs. 10.8 per patient-year PPY), inpatient visits (0.7 vs. 0.5 PPY), and longer mean length of stay (8.7 vs. 7.4 days); and had higher mean costs PPY for outpatient, inpatient, and pharmacy services (total: €5975 vs. €4399). Conclusions Patients with symptomatic obstructive HCM experienced greater clinical and economic burden than asymptomatic patients in Germany. Graphical Abstract

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