What question did this study set out to answer?

To assess the prevalence of hypertrophic cardiomyopathy (HCM) among patients with non-valvular atrial fibrillation (NVAF) and evaluate the associated increase in stroke risk.

January 2, 2019Thrombosis and HaemostasisOpen Access

Hypertrophic Cardiomyopathy in Patients with Atrial Fibrillation: Prevalence and Associated Stroke Risks in a Nationwide Cohort Study

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Why the study?

Nationwide data on HCM prevalence among AF patients were lacking, and the stroke risk attributable to HCM compared with other stroke risks in AF was unclear.

Does the presence of hypertrophic cardiomyopathy increase the risk of ischaemic stroke or systemic embolism in patients with non-valvular atrial fibrillation?

Population

979,784 patients with prevalent NVAF aged 18 years or older in Korea

Comparison

NVAF with HCM vs NVAF without HCM

Design

Nationwide cohort study

Authors

HJHyunjean JungYonsei University PYPil‐Sung YangElectrophysiology JSJung‐Hoon SungElectrophysiology

Discussion

Member takes

Implication

HCM may elevate stroke risk in NVAF; leaves open whether it modifies CHA2DS2-VASc thresholds in routine care.

Key Points

To assess the prevalence of hypertrophic cardiomyopathy (HCM) among patients with non-valvular atrial fibrillation (NVAF) and evaluate the associated increase in stroke risk.
Analyzed data from the Korean National Health Insurance Service database between January 1, 2005, and December 31, 2016.
Included 979,784 patients aged 18 years or older with prevalent non-valvular atrial fibrillation.
The overall prevalence of hypertrophic cardiomyopathy among NVAF patients was 1.1%, yet only 1,622 (15.3%) were receiving oral anticoagulants at the time of AF diagnosis.
Among oral anticoagulant-naïve patients, those with HCM demonstrated an increased risk of ischaemic stroke/systemic embolism compared with those without HCM (adjusted HR 1.55, 95% CI 1.48–1.63, p < 0.001).
Patients with NVAF and HCM who lacked any non-gender CHA2DS2-VASc risk factors had an ischaemic stroke/systemic embolism rate of 4.02 per 100 person-years, comparable to 4.07 per 100 person-years in NVAF patients without HCM who had a CHA2DS2-VASc score of 3.

Structured PICO

Does the presence of hypertrophic cardiomyopathy increase the risk of ischaemic stroke or systemic embolism in patients with non-valvular atrial fibrillation?

Population

979,784 patients aged 18 years or older with prevalent non-valvular atrial fibrillation (NVAF) from the Korean National Health Insurance Service database (2005-2016).

Intervention

Presence of hypertrophic cardiomyopathy (HCM)

Comparator

Absence of hypertrophic cardiomyopathy (without HCM)

Outcome

Ischaemic stroke/systemic embolismhard clinical

In patients with non-valvular atrial fibrillation, the presence of hypertrophic cardiomyopathy significantly increases the risk of ischaemic stroke and systemic embolism to a level equivalent to a CHA2DS2-VASc score of 3, yet oral anticoagulant use in this high-risk population remains suboptimal.

Cite This Study

Jung et al. (2019) studied this question.

synapsesocial.com/papers/6a72297ff44fa9f079dfbbf9 https://doi.org/10.1055/s-0038-1676818

Topics

Atrial fibrillation Anticoagulation in AF Hypertrophic cardiomyopathy Persistent AF management Heart failure

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Hypertrophic Cardiomyopathy in Patients with Atrial Fibrillation: Prevalence and Associated Stroke Risks in a Nationwide Cohort Study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Hypertrophic Cardiomyopathy in Patients with Atrial Fibrillation: Prevalence and Associated Stroke Risks in a Nationwide Cohort Study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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