Long-term survival after acute myocardial infarction in patients with hypertrophic cardiomyopathy
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Published on: April 17, 2021
Yin-Jian Yang1, Chao-Mei Fan1, Jin-Qing Yuan2
1Key Laboratory of Clinical Trial Research in Cardiovascular Drugs, Ministry of Health, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Insights
Patients with hypertrophic cardiomyopathy (HCM) and acute myocardial infarction (AMI) face worse long-term survival. This study highlights the increased mortality risk in HCM patients post-AMI compared to those without HCM.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Hypertrophic cardiomyopathy (HCM) is linked to poor prognosis.
- In-hospital mortality post-acute myocardial infarction (AMI) is similar for patients with and without HCM.
- Long-term survival differences after AMI in HCM patients remain unclear.
Purpose of the Study:
- To investigate long-term survival after AMI in patients with and without HCM.
- To compare all-cause mortality rates between these two groups.
Main Methods:
- Analysis of 91 patients with HCM and AMI (HCM group) and 91 matched controls without HCM (non-HCM group).
- Study endpoint was all-cause mortality.
- Follow-up duration of 4.9 ± 3.6 years.
Main Results:
- Overall, 27.5% mortality in the HCM group versus 14.3% in the non-HCM group (P=0.039).
- No significant difference in mortality during the first year post-AMI (3.3% vs 7.7%, P=0.177).
- After the first year, annual mortality was significantly higher in the HCM group (6.3%) compared to the non-HCM group (1.6%, P=0.001).
Conclusions:
- Patients with HCM experience worse long-term survival following AMI.
- HCM is an independent predictor of reduced long-term survival after AMI.
Background:
Hypertrophic cardiomyopathy (HCM) is associated with poor prognosis. It has been reported that there is no difference in in-hospital mortality after acute myocardial infarction (AMI) between patients with and without HCM. However, whether there is a difference in long-term survival after AMI between patients with and without HCM remains unclear.
Hypothesis:
Long-term survival after AMI is worse in patients with vs without HCM.
Methods:
The clinical profiles of 91 consecutive patients with HCM and AMI (HCM group) and 91 sex- and age-matched patients with AMI without HCM (non-HCM group) were analyzed. The study endpoint was all-cause mortality.
Results:
During a follow-up period of 4.9 ± 3.6 years, all-cause mortality occurred in 25 patients (27.5%) in the HCM group and 13 patients (14.3%) in the non-HCM group. The survival of the HCM group was inferior to that of the non-HCM group (log-rank P = 0.039). During the first year of follow-up, 3 deaths (3.3%) occurred in the HCM group and 7 deaths (7.7%) occurred in the non-HCM group (log-rank P = 0.177). Among patients who survived beyond the first year of follow-up (172 patients), the annual mortality rates were 6.3% (95% confidence interval: 4.0%-9.3%) in the HCM group and 1.6% (95% confidence interval: 0.6%-3.5%) in the non-HCM group (log-rank P = 0.001).
Conclusions:
AMI patients with HCM exhibited worse long-term survival than did AMI patients without HCM.
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