Title : Clinical application in the prediction of 2 and 5-year clinical outcome of Polish patients with HCM
Abstract:
Introduction: Hypertrophic cardiomyopathy (HCM) is a genetic disease-causing variety of life-threatening complications. Atrial fibrillation (AF) in HCM population constitutes an important step in progression of the disease. Recently developed tool – HCM-AF Risk Calculator validated in American population allows accurate prognosis of AF occurrence in HCM patients.
Aim: To assess clinical application of HCM-AF Risk Score in the prediction of 2 and 5-year clinical outcome of Polish patients with HCM.
Materials and methods: The retrospective cohort study included 54 consecutive patients with HCM (52% female, median age 59) and baseline sinus rhythm diagnosed at the 1st Chair and Clinic of Cardiology, Medical University of Silesia in Katowice in 01.01.2013 - 31.12.2016. Analysis involved clinical characteristics, laboratory tests, echocardiography, Holter monitoring, 2- and 5-year clinical outcome (total mortality, re-hospitalization, ICD implantation, heart failure (HF) regarding the baseline HCM-AF Risk Score.
Results: According to HCM-Risk Score stratification 2 patients (3.7%) from analyzed cohort had low, 3 patients (5.6%) had intermediate, and 49 patients (90.1%) had high risk of AF. Both in low and intermediate-risk groups one patient developed AF, all patients survived, and no patients presented HF progression within 2-year and 5-year follow-up. Whereas in high-risk group AF has been detected in 24 (48.9%) patients within 2-year-follow-up and 31 (63.3%) patients within 5 year-follow-up, total mortality was 46.9% and HF progression was significant, and. Moreover, in explicitly distinguished subgroup of extremely high risk of AF (HCM AF Risk Score>45) 16 patients (84.2%) in 2-year-follow-up and 19 (100%) patients in 5 year-follow-up developed AF.
Conclusions: HCM-AF Risk Score seems to be useful in both prediction of AF occurrence and clinical outcome in HCM patients. Polish HCM population is characterized by relatively high HCM-Risk Score coexisting with high AF occurrence thus AF screening should be obligatory in this group.
Keywords: Hypertrophic Cardiomyopathy; Atrial Fibrillation; HCM-AF
Audience Takeaway:
- Monitoring of HCM in Polish population
- Progression and management of HCM in 2- and 5-year follow-up
- Clinical application of novel risk assessment tools in HCM patients
- Insight into further development of risk assessment tools for HCM patients
