Female sex was associated with a higher unadjusted risk of cardiovascular death in hypertrophic cardiomyopathy (HR 1.37; 95% CI 1.02-1.82; P=0.03), which was largely explained by older age and symptoms.
Observational (n=3,247)
Yes
Does female sex affect the risk of cardiovascular death in patients with hypertrophic cardiomyopathy?
The apparent excess cardiovascular mortality in women with hypertrophic cardiomyopathy is largely explained by their older age and more advanced disease at presentation rather than female sex itself.
Hazard Ratio: 1.37 (95% CI 1.02–1.82)
p-value: p=0.03
Background Female sex has been associated with poor prognosis in hypertrophic cardiomyopathy (HCM), but the factors contributing to this disparity remain insufficiently defined. We aimed to clarify sex differences in clinical characteristics and factors associated with cardiovascular death in Japan. Methods This multicenter, retrospective observational study of HCM was conducted between January 1, 2006, and December 31, 2018 (REVEAL‐HCM study Multicenter Registry to Evaluate Risk Factors for Disease Progression, Sudden Cardiac Death and Adverse Clinical Outcomes in Japanese Patients With Hypertrophic Cardiomyopathy; UMIN000046932). Patients aged ≥16 years with HCM were enrolled. Baseline characteristics and clinical outcomes including cardiovascular death were assessed. Univariable and multivariable Cox proportional hazards models were used to identify factors associated with cardiovascular death. Results Of 3247 patients (median age, 67 years; 43% women), women were older and more symptomatic at presentation (52% New York Heart Association class II–IV versus 35% in men). Cardiovascular death was more common in women (hazard ratio HR, 1.37 95% CI, 1.02–1.82; P =0.03). In multivariable analysis, older age (per 1‐year increase; HR, 1.04 95% CI, 1.02–1.06), advanced New York Heart Association class (HR, 1.99 95% CI, 1.40–2.82), history of atrial fibrillation (HR, 1.55 95% CI, 1.10–2.18), greater maximal wall thickness indexed to body surface area (per 1‐mm/m 2 increase; HR, 1.12 95% CI, 1.06–1.20), and apical HCM (HR, 0.53 95% CI, 0.32–0.88) were independently associated with cardiovascular death, attenuating the HR for female sex. Conclusions Sex differences in clinical characteristics and outcomes were observed. The excess cardiovascular death in women with HCM was largely explained by older age, more advanced symptoms, greater indexed wall thickness, and sex‐specific differences in both the prevalence and prognostic impact of apical HCM.
Nakamura et al. (Tue,) conducted a observational in Hypertrophic cardiomyopathy (n=3,247). Female sex vs. Male sex was evaluated on Cardiovascular death (HR 1.37, 95% CI 1.02-1.82, p=0.03). Female sex was associated with a higher unadjusted risk of cardiovascular death in hypertrophic cardiomyopathy (HR 1.37; 95% CI 1.02-1.82; P=0.03), which was largely explained by older age and symptoms.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: