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Survival after alcohol septal ablation versus conservative therapy in obstructive hypertrophic cardiomyopathy
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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.
Keywords
obstructive hypertrophic cardiomyopathy, alcohol septal ablation, medical therapy, conservative therapy, survival
About this articleTitle
Survival after alcohol septal ablation versus conservative therapy in obstructive hypertrophic cardiomyopathy
Journal
Issue
Pages
657-664
Published online
2015-12-30
Page views
1753
Article views/downloads
2449
DOI
10.5603/CJ.a2015.0032
Pubmed
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
