1. Comparison of the new risk prediction model (HCM Risk-SCD) and classic risk factors for sudden death in patients with hypertrophic cardiomyopathy and defibrillator
- Author
-
José Peña-Hernández, Amalio Ruiz-Salas, Fernando Cabrera-Bueno, Carmen Medina-Palomo, José Manuel García-Pinilla, Alberto Barrera-Cordero, Javier Alzueta, Julia Fernández-Pastor, and Eduardo de Teresa
- Subjects
Adult ,Male ,medicine.medical_specialty ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,Ventricular tachycardia ,Sudden death ,Defibrillator ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Physiology (medical) ,Internal medicine ,Odds Ratio ,medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Family history ,Risk factor ,Retrospective Studies ,business.industry ,Hypertrophic cardiomyopathy ,Arrhythmias, Cardiac ,Retrospective cohort study ,Odds ratio ,Cardiomyopathy, Hypertrophic ,Middle Aged ,medicine.disease ,Confidence interval ,Defibrillators, Implantable ,Primary Prevention ,Death, Sudden, Cardiac ,Logistic Models ,Spain ,cardiovascular system ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims Hypertrophic cardiomyopathy is one of the main causes of sudden death in young people. Recent clinical practice guidelines include a risk prediction model for sudden death (HCM Risk-SCD), which facilitates the decision of whether to implant a defibrillator. The aim of our study was to ascertain the percentage of events in our series of primary prevention implantable cardioverter-defibrillator recipients with hypertrophic cardiomyopathy and whether HCM Risk-SCD predicts the onset of arrhythmic events. Methods and results This was an observational, retrospective cohort study, which included 48 primary prevention defibrillator recipient patients with HCM. We compiled their demographic and clinical characteristics, estimated 5-year risk using HCM Risk-SCD, and collected the documentation on arrhythmias during follow-up. The majority was male (66.7%) and mean age at implantation was 44.44 ± 14.46 years. Non-sustained ventricular tachycardia was the most prevalent risk factor (66.67%), followed by a family history of sudden death (47.92%). Mean HCM Risk-SCD was 6.15 ± 5.01%. HCM Risk-SCD was the only factor independently associated with the onset of ventricular tachyarrhythmia, above any other classic risk factor or association [odds ratio = 1.46 (95% confidence interval 1.051–2.013); P = 0.02]. None of the 11 patients estimated as low risk using HCM Risk-SCD suffered any appropriate events ( P < 0.05). Conclusions During an average follow-up of 4 years, 16.67% presented appropriate events (4.16%/year). HCM Risk-SCD predicted the onset of events more suitably than classic risk factors.
- Published
- 2015