Key result
Myectomy in HOCM patients with severe hypertrophy was associated with lower annual rates of cardiovascular mortality (0.84% vs 2.04%, p=0.041) and sudden cardiac death compared to medical therapy.
Why the study?
Does myectomy reduce cardiovascular mortality and sudden cardiac death in patients with HOCM and severe left ventricular hypertrophy compared to medical therapy alone?
Cohort (n=244)
No
Does myectomy reduce cardiovascular mortality and sudden cardiac death in patients with HOCM and severe left ventricular hypertrophy compared to medical therapy alone?
Absolute Event Rate: 0.84% vs 2.04%
p-value: p=0.041
Myectomy is associated with a significantly lower risk of cardiovascular death and sudden cardiac death compared to medical therapy alone in patients with HOCM and severe left ventricular hypertrophy.
May support myectomy consideration in severe HOCM; hypothesis-generating and requires randomized confirmation.
OBJECTIVES: Patients with hypertrophic obstructive cardiomyopathy (HOCM) and severe left ventricular hypertrophy (maximal left ventricular wall thickness ≥30 mm) are at high risk of sudden cardiac death (SCD). In this study, we aimed to determine whether HOCM patients with severe hypertrophy had a lower incidence of SCD after myectomy. METHODS: HOCM patients with severe hypertrophy were consecutively enrolled from Fuwai Hospital in China between 2000 and 2013. Long-term outcomes were retrospectively compared between the 2 groups, namely the myectomy group and medical group. RESULTS: A total of 244 patients (118 in the myectomy group and 126 in the medical group) were involved. The mean follow-up durations for the myectomy and medical groups were 5.07 ± 3.73 and 6.23 ± 4.15 years, respectively. During the follow-up period, the annual cardiovascular mortality rate was 0.84% in the myectomy group and 2.04% in the medical group (p = 0.041). The annual SCD rate was 0.33% in the myectomy group and 1.40% in the medical group (p = 0.040). Multivariate Cox regression analysis showed that myectomy was independently associated with lower rates of cardiovascular death and SCD. CONCLUSIONS: In HOCM patients with severe hypertrophy, those that underwent myectomy had a lower risk of cardiovascular death and SCD than those treated with medicines only.
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An et al. (2018) conducted a cohort in Hypertrophic Obstructive Cardiomyopathy with Severe Left Ventricular Hypertrophy (n=244). Myectomy vs. Medical therapy was evaluated on Annual cardiovascular mortality rate (p=0.041). Myectomy in HOCM patients with severe hypertrophy was associated with lower annual rates of cardiovascular mortality (0.84% vs 2.04%, p=0.041) and sudden cardiac death compared to medical therapy.
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