Vol 22, No 6 (2015)
Original articles
Published online: 2015-12-30

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Survival after alcohol septal ablation versus conservative therapy in obstructive hypertrophic cardiomyopathy

Yin-Jian Yang, Chao-Mei Fan, Jin-Qing Yuan, Shu-Bin Qiao, Feng-Huan Hu, Xi-Ying Guo, Yi-Shi Li
DOI: 10.5603/CJ.a2015.0032
Pubmed: 26100829
Cardiol J 2015;22(6):657-664.

Abstract

Background: The impact of alcohol septal ablation (ASA) on the survival of patients with drug-refractory obstructive hypertrophic cardiomyopathy (HCM) remains unresolved. The aim of this study was to compare survival after ASA vs. conservative therapy.

Methods: We studied a consecutive cohort of 274 patients with severe drug-refractory obstructive HCM, 229 in ASA group and 45 in conservative group. The primary endpoint was a composite of all-cause mortality and aborted cardiac arrest.

Results: With a median follow-up of 4.3 years, primary endpoint occurred in 13 (5.7%) patients in the ASA group, and 8 (17.8%) patients in the conservative group. The 5- and 10-year survival free from primary endpoint of the ASA group (94.5% and 93.0%, respectively) was significantly better than that of the conservative group (78.3% and 72.2%, respectively, log-rank p = 0.009). Independent determinants of primary endpoint were ASA therapy (hazard ratio [HR] 0.22; 95% confidence interval [CI] 0.08–0.60; p = 0.003) and maximal septal thickness (HR 1.14; 95% CI 1.03–1.27; p = 0.011).

Conclusions: In patients with severe drug-refractory obstructive HCM, survival after ASA is favorable and better than that of conservative therapy. ASA seems to improve survival.