Predictive Value of Existing Prediction Models for Short-Term Outcomes after Percutaneous Intramyocardial Septal
Jiaqi Yin1, Shengjun Ta1, Jing Wang1
1Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Cardiology
|March 3, 2026
Summary
EuroSCORE-II and STS-PROM predict major adverse cardiovascular events after Percutaneous IntraMyocardial Septal Radiofrequency Ablation (PIMSRA) in hypertrophic obstructive cardiomyopathy (HOCM) patients. Developing PIMSRA-specific risk models is crucial for patient safety.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Percutaneous IntraMyocardial Septal Radiofrequency Ablation (PIMSRA) is a novel septal reduction therapy for drug-refractory hypertrophic obstructive cardiomyopathy (HOCM).
- Existing risk stratification tools like EuroSCORE-II, STS-PROM, and HCM Risk-SCD lack specific validation for PIMSRA.
- Accurate risk assessment is vital for patient selection and management in HOCM undergoing PIMSRA.
Purpose of the Study:
- To evaluate the predictive value of EuroSCORE-II, STS-PROM, and HCM Risk-SCD for short-term adverse events in HOCM patients undergoing PIMSRA.
- To identify independent predictors of major adverse cardiovascular events (MACE) following PIMSRA.
- To inform the development of PIMSRA-specific risk prediction models.
Main Methods:
- Retrospective analysis of 571 HOCM patients treated with PIMSRA from October 2016 to June 2024.
- Calculation of pre-procedural risk scores using EuroSCORE-II, STS-PROM, and HCM Risk-SCD.
- Assessment of 30-day MACE, including all-cause death, cardiac tamponade, arrhythmic events, cardiogenic shock, and stroke.
Main Results:
- The 30-day MACE incidence was 10.7% (61 patients).
- EuroSCORE-II (OR=2.30) and STS-PROM (OR=1.18) were independently associated with 30-day MACE.
- History of syncope and peak left ventricular outflow tract (LVOT) gradient also predicted MACE.
- AUROC values indicated moderate predictive ability for EuroSCORE-II (0.657) and STS-PROM (0.623), with lower performance for HCM Risk-SCD (0.550).
Conclusions:
- EuroSCORE-II and STS-PROM demonstrate some predictive value for MACE post-PIMSRA, alongside clinical factors like syncope history and LVOT gradient.
- Current risk scores have limitations in accurately predicting outcomes for PIMSRA.
- There is a critical need for developing dedicated risk prediction models tailored to SRT procedures like PIMSRA.
