Fibrin Clot Properties and Thrombin Generation in Hypertrophic Cardiomyopathy

Although most patients with hypertrophic cardiomyopathy (HCM) are oligosymptomatic with normal life expectancy, approximately one-fifth experience increased morbidity and mortality.[1] There are a wide range of clinical manifestations of HCM including diastolic dysfunction, end-stage heart failure (HF), ischemia, left ventricular outflow tract (LVOT) obstruction, atrial fibrillation (AF), syncope, and sudden cardiac death (SCD). Thromboembolic (TE) events such as stroke are observed predominantly in patients with AF.[1] [2] In a landmark study, TE complications were reported in 51 (6%) out of 900 ambulatory HCM patients over a period of 7 ± 7 years with an overall incidence of 0.8%/year and 1.9% for those > 60 years old. The independent predictors of TE complications were found to be AF, age, and HF. Of note, in 6 (12%) patients with TE complications, the etiology was not established.[3]