open access

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.

open access

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

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.

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.

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Keywords

obstructive hypertrophic cardiomyopathy, alcohol septal ablation, medical therapy, conservative therapy, survival

About this article
Title

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

Journal

Cardiology Journal

Issue

Vol 22, No 6 (2015)

Pages

657-664

Published online

2015-12-30

DOI

10.5603/CJ.a2015.0032

Pubmed

26100829

Bibliographic record

Cardiol J 2015;22(6):657-664.

Keywords

obstructive hypertrophic cardiomyopathy
alcohol septal ablation
medical therapy
conservative therapy
survival

Authors

Yin-Jian Yang
Chao-Mei Fan
Jin-Qing Yuan
Shu-Bin Qiao
Feng-Huan Hu
Xi-Ying Guo
Yi-Shi Li

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