Rates of Sudden Cardiac Death in Hypertrophic Cardiomyopathy Falling in Recent Years

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A new study is providing insight into the impact of advances in care on risk of mortality from sudden cardiac death among patients with hypertrophic cardiomyopathy.

Regarded as the largest single cause of premature death among this patient population, results of the study, which leveraged more than 470,000 patient-years of data from nearly 100 studies, suggest the risk of mortality from SCD in patients with hypertrophic cardiomyopathy, with results pointing to a reduction in risk of death more than 70% among those in North America for the 2015-present time period compared to 2000 or earlier.

Led by Martin Maron, MD, director of the Hypertrophic Cardiomyopathy Center at Lahey Hospital, the study was launched with the intent of exploring how changes in management over the last several decades may have influenced risk of SCD among patients with hypertrophic cardiomyopathy. With this in mind, Maron and a team of colleagues designed the current study to assess contemporary trends in risk of morality from a meta-analysis of study data on the subject.

Through a search of electronic databases, 98 studies meeting inclusion criteria were identified by investigators. These studies included data from 70,150 patients with 431,407 patient-years of follow-up data. For the purpose of analysis, a random-effects model was used to pool estimates for overall incidence rates for time-era, geographic region, and age group. Investigators pointed out analyses were planned to assess rates before and after 200, as well as in 5-year intervals following 2000 to assess changes in SCD rates.

Upon analysis, results indicated the overall rate of SCD in hypertrophic cardiomyopathy was 0.43 per year (95% CI, 0.37-0.50%; I2=75%), with a total of 1938 events occurring during the follow-up period. Further analysis suggested patients less than 18 years of age had a more than 2-fold increase in risk for SCD than their counterparts aged 18-60 years of age (IR: 1.09% [95% CI, 0.69-1.73%] vs IR: 0.43% [95% CI, 0.37%-0.50%]; P <.01).

In analyses assessing more contemporary trends, results pointed to significantly lower rates of SCD among patients with hypertrophic cardiomyopathy from 2015-present compared to prior to 2000 (IR: 0.32% [95% CI, 0.20-0.52% vs IR: 0.73% [95% CI, 0.53-1.02%], respectively). Investigators also noted the rate of reported SCD from 2015-present was lowest in North America (IR: 0.28% [95% CI, 0.18-0.43%])and greatest in Asia (IR: 0.67% [95% CI, 0.54-0.84%]).

At the Heart Failure Society of America (HFSA) 2022 annual scientific meeting, our editorial team caught up with Maron to discuss data from the conference. After those conversations, Maron provided further insight into the present study and what it is like to specialize in hypertrophic cardiomyopathy during a time where the field is experiencing so many significant advances.

This study, “Temporal and Global Trends of the Incidence of Sudden Cardiac Death in Hypertrophic Cardiomyopathy,” was published in JACC: Clinical Electrophysiology.