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Long-Term Impact of Frailty on Outcomes Following Alcohol Septal Ablation in Hypertrophic Obstructive Cardiomyopathy

Hritvik Jain1, Nandan Patel2, Jyoti Jain3

  • 1Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, India. Electronic address: https://twitter.com/HritvikJain.

JACC. Advances
|May 27, 2026
PubMed

Insights

Frailty significantly increases long-term mortality and adverse events in patients undergoing alcohol septal ablation (ASA) for hypertrophic obstructive cardiomyopathy (HOCM). Frail individuals face higher risks of death, major adverse events, and readmission post-procedure.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatrics

Background:

  • Limited data exist on frailty's impact in patients undergoing alcohol septal ablation (ASA) for hypertrophic obstructive cardiomyopathy (HOCM).
  • Understanding frailty's role is crucial for risk stratification and patient management in HOCM treatment.

Purpose of the Study:

  • To evaluate the impact of frailty on long-term clinical outcomes in patients undergoing ASA for HOCM.
  • To compare mortality and adverse event rates between frail and nonfrail HOCM patients treated with ASA.

Main Methods:

  • Retrospective cohort study using the United States Collaborative Network (2005-2025).
  • Patients with HOCM undergoing ASA were stratified into frail and nonfrail groups.
  • Propensity-score matching (1:1) and survival analyses (Kaplan-Meier, Cox regression) were employed.

Main Results:

  • Frail patients (5.8%) had significantly higher all-cause mortality at all follow-ups (10-year HR: 1.40).
  • Frail patients showed increased risks of major adverse cardiac and cerebrovascular events, ischemic stroke, heart failure exacerbation, major bleeding, and readmission.
  • No significant differences were observed for acute myocardial infarction, sudden cardiac arrest, or need for antiarrhythmic drugs/cardioversion.

Conclusions:

  • Frailty is associated with increased long-term mortality and adverse clinical outcomes following ASA for HOCM.
  • These findings highlight the importance of assessing frailty in HOCM patients considered for ASA.
Abstract

Keywords:
alcohol septal ablationfrailtyhypertrophic cardiomyopathyoutcomesrisk stratificationseptal reduction

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