1. Validation of ACC/AHA and ESC Sudden Cardiac Death Risk Guidelines in Diverse Hypertrophic Cardiomyopathy Cohort: Stratification HCM Study.
- Author
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Oliveira Antunes M, Fernandes F, Arteaga-Fernandez E, Alvarez Ramires FJ, Machado Correia V, Novaes Cardoso J, Romero CE, Sousa HM, Soliani MT, Dal Piaz MRR, Rodrigues Gandarella AD, Rocha Teixeira RG, Mady C, Assis Moura Tavares C, Guimarães PO, and Madrini Junior V
- Subjects
- Humans, Male, Female, Retrospective Studies, Middle Aged, Risk Assessment methods, United States epidemiology, Brazil epidemiology, Risk Factors, Adult, Follow-Up Studies, Cardiology, Europe epidemiology, Societies, Medical, Death, Sudden, Cardiac prevention & control, Death, Sudden, Cardiac epidemiology, Death, Sudden, Cardiac etiology, Cardiomyopathy, Hypertrophic complications, Cardiomyopathy, Hypertrophic mortality, American Heart Association, Practice Guidelines as Topic
- Abstract
Background: Sudden cardiac death (SCD) is a major concern in patients with hypertrophic cardiomyopathy (HCM). The American College of Cardiology/American Heart Association (ACC/AHA) and the European Society of Cardiology (ESC) have different guidelines for SCD risk stratification. Their comparative performance in diverse populations remains uncertain., Objective: Evaluate the performance of the 2020 ACC/AHA and 2014 ESC guidelines for SCD stratification in a Brazilian cohort with HCM., Methods: This retrospective cohort study included patients diagnosed with HCM who were followed in a dedicated clinic at a tertiary hospital in Brazil. The primary outcome was SCD, aborted cardiac arrest due to ventricular fibrillation (VF), sustained ventricular tachycardia (SVT), an episode of VF or SVT, or appropriate ICD therapy. Risk prediction models were assessed using the C-index., Results: A total of 187 patients were included, with a mean follow-up of 8.3 years. The 2020 ACC/AHA guidelines classified 106 (56%) patients as high-risk for SCD, while the 2014 ESC guidelines identified 54 (29%). The primary outcome occurred in 12% of the high-risk group identified by the ACC/AHA guidelines and 13% of the high-risk group identified by the ESC guidelines. Both guidelines showed low discriminatory power for SCD risk in this Brazilian cohort, with AUC values of 0.634 and 0.581 for the ACC/AHA and ESC guidelines, respectively., Conclusions: The 2020 ACC/AHA and 2014 ESC guidelines have limitations in predicting SCD events and defining ICD indications in Brazilian HCM patients. Further studies are needed to refine risk stratification and optimize SCD prevention in this population., Competing Interests: All authors declare that there are no conflicts of interest related to this study. We have no financial or personal relationships with any entities that could have influenced the work reported in this paper. Specifically, no author has shareholding in or has received grants, consultancy fees, or any other form of compensation from companies whose products are featured in this manuscript or that manufacture competing products. This statement is made in accordance with the requirements of the European Journal of Heart Failure and the ICMJE Conflicts of Interest disclosure form. Each author has submitted a completed disclosure form along with this submission., (Copyright: © 2024 The Author(s).)
- Published
- 2024
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