Sex differences in in-hospital outcomes in hypertrophic cardiomyopathy: A nationwide analysis

Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiomyopathy. HCM is associated with heart failure (HF), arrhythmia, and acute coronary syndrome (ACS). The influence of sex on in-hospital outcomes in HCM is unknown. We conducted a nationwide analysis to compare outcomes between women and men with HCM hospitalized for HF, arrhythmias, or ACS.

This retrospective cohort analysis of the 2022 National Inpatient Sample (NIS) identified adults hospitalized with acute HF, arrhythmia, or ACS plus a secondary diagnosis of HCM. The primary outcome was in-hospital mortality. Secondary outcomes included length of stay (LOS) and total hospital charges. Multivariable logistic and linear regression models were used to adjust for demographics and comorbidities.

Among 5,089 HCM admissions (51.1 % female; mean age 65.9 years), women were older (68.9 vs. 62.1 years) and more often admitted for acute HF. Arrhythmia presentations were similarly common in both sexes, and men more frequently had ACS. In-hospital mortality was 1.7 % and did not differ by sex after adjustment (adjusted odds ratio 1.3, p = 0.63). Mean LOS was 4.3 days and was similar between sexes. Total hospitalization charges showed no significant sex difference for HF or ACS, but men incurred higher charges for arrhythmias.

In this nationwide analysis, sex was not an independent predictor of in-hospital mortality or LOS among admissions with HCM and acute cardiovascular events. Resource utilization was broadly comparable except for arrhythmia admissions, where charges were substantially higher in men. Differences in hospital charges suggest that differences in management may exist.