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Risk stratification for sudden cardiac death in hypertrophic cardiomyopathy: systematic review of clinical risk markers

Christiaans, I; van Engelen, K; van Langen, IM; Birnie, E; Bonsel, GJ; Elliott, PM; Wilde, AAM; (2010) Risk stratification for sudden cardiac death in hypertrophic cardiomyopathy: systematic review of clinical risk markers. EUROPACE , 12 (3) 313 - 321. 10.1093/europace/eup431.

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Abstract

We performed a systematic literature review of recommended 'major' and 'possible' clinical risk markers for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM). We searched the Medline, Embase and Cochrane databases for articles published between 1971 and 2007. We included English language reports on HCM patients containing follow-up data on the endpoint (sudden) cardiac death using survival analysis. Analysis was undertaken using the quality of reporting of meta-analyses (QUORUM) statement checklist. The quality was checked using a quality assessment form from the Cochrane Collaboration. Thirty studies met inclusion criteria and passed quality assessment. The use of the six major risk factors (previous cardiac arrest or sustained ventricular tachycardia, non-sustained ventricular tachycardia, extreme left ventricular hypertrophy, unexplained syncope, abnormal blood pressure response, and family history of sudden death) in risk stratification for SCD as recommended by international guidelines was supported by the literature. In addition, left ventricular outflow tract obstruction seems associated with a higher risk of SCD. Our systematic review provides sound evidence for the use of the six major risk factors for SCD in the risk stratification of HCM patients. Left ventricular outflow tract obstruction could be included in the overall risk profile of patients with a marked left ventricular outflow gradient under basal conditions.

Type: Article
Title: Risk stratification for sudden cardiac death in hypertrophic cardiomyopathy: systematic review of clinical risk markers
DOI: 10.1093/europace/eup431
Keywords: Hypertrophic cardiomyopathy, Cardiomyopathy, Prognosis, Risk factors, Sudden death, MYOSIN HEAVY-CHAIN, BINDING-PROTEIN-C, VENTRICULAR ELECTROMECHANICAL ASYNCHRONY, GENOTYPE-PHENOTYPE CORRELATIONS, OUTFLOW TRACT OBSTRUCTION, PROGNOSTIC IMPLICATIONS, ATRIAL-FIBRILLATION, PATIENT POPULATION, NATURAL-HISTORY, GENE-MUTATIONS
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science > Clinical Science
URI: http://discovery.ucl.ac.uk/id/eprint/118424
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