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Mortality Among Referral Patients With Hypertrophic Cardiomyopathy vs the General European Population

Lorenzini, M; Anastasiou, Z; O'Mahony, C; Guttman, OP; Gimeno, JR; Monserrat, L; Anastasakis, A; ... Hypertrophic Cardiomyopathy Outcomes investigators, .; + view all (2019) Mortality Among Referral Patients With Hypertrophic Cardiomyopathy vs the General European Population. JAMA Cardiology 10.1001/jamacardio.2019.4534. (In press).

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Abstract

IMPORTANCE: It is unclear whether hypertrophic cardiomyopathy (HCM) conveys excess mortality when compared with the general population. OBJECTIVE: To compare the survival of patients with HCM with that of the general European population. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of 4893 consecutive adult patients with HCM presenting at 7 European referral centers between 1980 and 2013. The data were analyzed between April 2018 and August 2019. MAIN OUTCOMES AND MEASURES: Survival was compared using standardized mortality ratios (SMRs) calculated with data from Eurostat, stratified by study period, country, sex, and age, and using a composite end point in the HCM cohort of all-cause mortality, aborted sudden cardiac death, and heart transplant. RESULTS: Of 4893 patients with HCM, 3126 (63.9%) were male, and the mean (SD) age at presentation was 49.2 (16.4) years. During a median follow-up of 6.2 years (interquartile range, 3.1-9.8 years), 721 patients (14.7%) reached the composite end point. Compared with the general population, patients with HCM had excess mortality throughout the age spectrum (SMR, 2.0, 95% CI, 1.48-2.63). Excess mortality was highest among patients presenting prior to the year 2000 but persisted in the cohort presenting between 2006 and 2013 (SMR, 1.84; 95% CI, 1.55-2.18). Women had higher excess mortality than men (SMR, 2.66; 95% CI, 2.38-2.97; vs SMR, 1.68; 95% CI, 1.52-1.85; P < .001). CONCLUSION AND RELEVANCE: Among patients referred to European specialty centers, HCM was associated with significant excess mortality through the life course. Although there have been improvements in survival with time, potentially reflecting improved treatments for HCM, these findings highlight the need for more research into the causes of excess mortality among patients with HCM and for better risk stratification.

Type: Article
Title: Mortality Among Referral Patients With Hypertrophic Cardiomyopathy vs the General European Population
Location: United States
DOI: 10.1001/jamacardio.2019.4534
Publisher version: https://doi.org/10.1001/jamacardio.2019.4534
Language: English
Additional information: This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Cardiology, Heart Failure
UCL classification: UCL
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 Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Statistical Science
URI: https://discovery.ucl.ac.uk/id/eprint/10087582
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