Key result
Hypertrophic cardiomyopathy patients who underwent coronary revascularization had a significantly higher risk of cardiovascular death (adjusted HR 2.27) compared to matched non-HCM controls.
Why the study?
Data are limited on long-term outcomes in patients with hypertrophic cardiomyopathy and significant CAD requiring revascularization.
Do patients with hypertrophic cardiomyopathy who undergo coronary revascularization have worse long-term cardiovascular outcomes compared to revascularized patients without hypertrophic cardiomyopathy?
Cohort (n=2,399)
Do patients with hypertrophic cardiomyopathy who undergo coronary revascularization have worse long-term cardiovascular outcomes compared to revascularized patients without hypertrophic cardiomyopathy?
Patients with hypertrophic cardiomyopathy requiring coronary revascularization face a significantly higher long-term risk of mortality and major cardiovascular events compared to revascularized patients without HCM.
Answers are grounded in this paper and cite their sources.
HCM patients post-revascularization show higher CV event rates; leaves open whether intensified surveillance or targeted therapies improve outcomes.
Limited data are available on the long-term outcomes in patients with hypertrophic cardiomyopathy (HCM) patients with significant coronary artery disease (CAD) requiring revascularization. We investigated the risk of cardiovascular outcomes in HCM patients who underwent coronary revascularization compared to the control group without HCM. HCM patients aged ≥ 20 years were enrolled from the Korean National Health Insurance Database. Information on the diagnosis and previous medical history was obtained from the claims data. Cardiovascular outcomes were identified during 8-year after coronary revascularization in HCM patients (HCM group) and matched controls without HCM (non-HCM control group). A total of 431 patients in the HCM group and 1968 in the non-HCM control group were analyzed. The risk of all-cause death, cardiovascular death, sudden cardiac death (SCD), ischemic stroke, and hospitalization due to heart failure was significantly higher in the HCM group than in the non-HCM group, with prominent risk increase of cardiovascular death (adjusted hazard ratio [HR] 2.27, 95% confidence interval [CI] 1.63-3.15, P < 0.001) and ischemic stroke (adjusted HR 2.38, 95% CI 1.55-3.64, P < 0.001). Beyond 1-year after revascularization, the HCM group still had a significantly higher risk of cardiovascular death, SCD, and ventricular fibrillation/tachycardia compared to the non-HCM group. Mortality and major cardiovascular outcomes occurred more frequently in HCM patients with significant CAD requiring revascularization, compared to the matched non-HCM control group. Active and regular surveillance for concomitant risk factors and relevant intervention are warranted in HCM patients at increased risk for CAD.
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Rhee et al. (2023) conducted a cohort in Hypertrophic cardiomyopathy with significant coronary artery disease requiring revascularization (n=2,399). Hypertrophic cardiomyopathy vs. Non-HCM control group was evaluated on Cardiovascular death (HR 2.27, 95% CI 1.63-3.15, p=<0.001). Hypertrophic cardiomyopathy patients who underwent coronary revascularization had a significantly higher risk of cardiovascular death (adjusted HR 2.27) compared to matched non-HCM controls.
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