Augmented risk of ischemic stroke in hypertrophic cardiomyopathy patients without documented atrial fibrillation

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You-Jung Choi1,2, Bongseong Kim3, Tae-Min Rhee2,4

  • 1Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital & Korea University College of Medicine, Seoul, Korea.

Scientific Reports
|September 22, 2022
PubMed

Insights

Hypertrophic cardiomyopathy (HCM) patients without atrial fibrillation (AF) face a higher risk of ischemic stroke (IS). This risk is particularly elevated in older individuals and those with heart failure, highlighting a critical need for proactive management.

Area of Science:

  • Cardiology
  • Neurology
  • Public Health

Background:

  • Atrial fibrillation (AF) is a known risk factor for ischemic stroke (IS) in hypertrophic cardiomyopathy (HCM).
  • The risk of IS in HCM patients without documented AF is less understood.
  • This study addresses the underrecognized risk of IS in HCM patients without AF.

Purpose of the Study:

  • To investigate the incidence and risk factors of IS in HCM patients without documented AF.
  • To compare the risk of IS in HCM patients without AF to a matched control group.
  • To identify specific subgroups within the HCM population at higher risk for IS.

Main Methods:

  • Nationwide population-based cohort study using the Korean National Health Insurance database.
  • Included 8,328 HCM patients without documented AF and 16,656 matched non-HCM controls (2010-2016).
  • Propensity score matching was used to control for confounding factors; primary outcome was incident IS.

Main Results:

  • The incidence of IS was significantly higher in the HCM group (3.9%) compared to controls (2.7%).
  • Overall IS incidence was 0.72/100 person-years in HCM patients versus 0.44/100 person-years in controls (HR 1.64).
  • Age ≥ 65 years (aHR 2.74) and chronic heart failure (aHR 1.75) were independent risk factors for IS in HCM patients without AF.

Conclusions:

  • HCM patients without documented AF have an elevated risk of IS.
  • Older age (≥ 65 years) and co-existing chronic heart failure significantly increase IS risk in this population.
  • These findings emphasize the importance of risk stratification and management for IS in HCM patients, even in the absence of AF.

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