Key result
The 2018 JCS/JHFS guideline achieved fair discrimination for sudden cardiac death at 5 years (AUC 0.75) and significantly separated Class IIa from Class IIb risk groups (6.7% vs. 4.9%, P=0.006).
Why the study?
Does the 2018 JCS/JHFS guideline framework accurately predict sudden cardiac death in Japanese patients with hypertrophic cardiomyopathy compared to contemporary ACC/AHA and ESC frameworks?
Does the 2018 JCS/JHFS guideline framework accurately predict sudden cardiac death in Japanese patients with hypertrophic cardiomyopathy compared to contemporary ACC/AHA and ESC frameworks?
Answers are grounded in this paper and cite their sources.
The 2018 JCS/JHFS guideline provides fair discrimination for sudden cardiac death in Japanese HCM patients but does not significantly improve reclassification over contemporary US and European guidelines.
years (area under the curve 0.75, 95% confidence interval 0.71-0.80)and, crucially, separated Class IIa from Class IIb (5-year cumulative incidence 6.7% vs. 4.9%, P=0.006).On the other hand, when the Class IIa threshold was used to simulate implantable cardioverter defibrillator (ICD) decisions, net reclassification improvement over contemporary American College of Cardiology (ACC)/American Heart Association (AHA) 2024 and European Society of Cardiology (ESC) 2023 frameworks was not significant.S udden cardiac death (SCD) remains the most consequential event in hypertrophic cardiomyopathy (HCM).The 2018 Japanese Circulation Society/ Japanese Heart Failure Society (JCS/JHFS) guideline sought to organize everyday decision-making into a stepwise pathway tailored to Japanese practice and phenotypes, 1 and in this issue of the Journal, a new multicenter validation by Amano et al. tests how this framework performs in a large, real-world Japanese cohort and clarifies both its strengths and faults. 2 In 3,547 patients followed for a median of 5.8 years, SCD or an equivalent event occurred in 7.0%.The guideline achieved fair discrimination at 5Article p ????The opinions expressed in this article are not necessarily those of the editors or of the Japanese Circulation Society.
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Kenya Kusunose (2025) conducted an editorial in Hypertrophic cardiomyopathy (n=3,547). 2018 JCS/JHFS guideline risk stratification vs. ACC/AHA 2024 and ESC 2023 frameworks was evaluated on Discrimination for sudden cardiac death or equivalent event at 5 years (AUC 0.75, 95% CI 0.71-0.80). The 2018 JCS/JHFS guideline achieved fair discrimination for sudden cardiac death at 5 years (AUC 0.75) and significantly separated Class IIa from Class IIb risk groups (6.7% vs. 4.9%, P=0.006).
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