Key result
Patients with hypertrophic cardiomyopathy undergoing left atrial appendage closure had a significantly higher rate of combined death and stroke than matched controls (26.67% vs 3.33%, P=0.024).
Why the study?
HCM patients with AF are at high risk for stroke, and LAAC is a promising alternative for stroke prevention, prompting a review of clinical outcomes at the authors' center.
Does the presence of hypertrophic cardiomyopathy affect the clinical outcomes of death and stroke in atrial fibrillation patients undergoing left atrial appendage closure?
Case-Control (n=74)
No
Does the presence of hypertrophic cardiomyopathy affect the clinical outcomes of death and stroke in atrial fibrillation patients undergoing left atrial appendage closure?
Absolute Event Rate: 26.67% vs 3.33%
p-value: p=.024
In patients with atrial fibrillation undergoing left atrial appendage closure, the presence of hypertrophic cardiomyopathy is associated with a significantly higher long-term risk of stroke and death compared to non-HCM patients.
HCM associated with higher death/stroke after LAA closure; leaves open optimal AF prevention strategies in this subgroup.
Hypertrophic cardiomyopathy (HCM) patients with atrial fibrillation (AF) are at high risk for stroke. Left atrial appendage closure (LAAC) is a promising alternative for stroke prevention in AF patients. We aimed to review the clinical outcomes of patients with AF and HCM at our center. We reviewed 673 patients who underwent LAAC implantation from 2014 to 2021 in a tertiary center, of whom 15 had HCM. AF Patients with HCM were compared with sex and age matched controls who also underwent LAAC. From 2014 to 2021, 673 AF patients received LAAC in a single center, of whom, 15 patients had HCM. LAAC devices were successfully implanted in 14 HCM patients and 59 patients in the control group. During the follow-up period (median 1151 days range: 132-2457 days), 2 HCM patient had ischemic strokes. There were another 2 HCM patients who had sudden cardiac death (SCD). Compared with the control, HCM patients had higher cumulative rate of combined death and stroke (26.67% vs 3.33%, P = .024). In our initial clinical experience, the cumulative stroke and death rate of the HCM patients was significantly higher than that of the non-HCM patients.
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Liu et al. (2023) conducted a case-control in Atrial fibrillation and hypertrophic cardiomyopathy (n=74). Hypertrophic cardiomyopathy vs. Non-HCM patients was evaluated on combined death and stroke (p=.024). Patients with hypertrophic cardiomyopathy undergoing left atrial appendage closure had a significantly higher rate of combined death and stroke than matched controls (26.67% vs 3.33%, P=0.024).
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