Analysis of the characteristics of thromboembolic events in patients with hypertrophic cardiomyopathy_Chinese Journal of Evidence-Based Medicine

Authors：

YAN Xiaolong ^1,2 ,  HE Sen ¹ , CHEN Xiaoping ¹

1. Cardiac Cath Lab, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;
2. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;

Corresponding?author：

HE Sen, Email: hesensubmit@163.com

Keywords：

Hypertrophic cardiomyopathy; Thrombo embolism; Clinical feature; Chinese population

DOI：

10.7507/1672-2531.202109103

Video：

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Objective To analyze the clinical characteristics of thrombo embolism (TE) in Chinese hypertrophic cardiomyopathy (HCM) patients. Methods This study retrospectively analyzed HCM patients admitted to West China Hospital of Sichuan University. The endpoints were defined as a composite of TE events, including ischemic stroke, transient ischemic attack, and peripheral arterial embolization. Results A total of 537 HCM patients were included with a median follow-up of 4.2 years. Forty-two patients reached the TE endpoint and the incidence was 1.9%. The annual incidence of TE was approximately 1.1% and 6.6% for HCM patients without/with atrial fibrillation, respectively. The recurrence rate of TE was high (approximately 26.2%). The mean age was 66.4±13.7 years for the first TE, and the incidence of TE was significantly increased at age ≥70 years. Conclusion The incidence of TE is high in HCM patients, especially in those with atrial fibrillation, and the recurrence rate of TE is also high.

Citation： YAN Xiaolong, HE Sen, CHEN Xiaoping. Analysis of the characteristics of thromboembolic events in patients with hypertrophic cardiomyopathy. Chinese Journal of Evidence-Based Medicine, 2022, 22(1): 31-36. doi: 10.7507/1672-2531.202109103 Copy

1.	Gersh BJ, Maron BJ, Bonow RO, et al. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: a report of the American college of cardiology foundation/American heart association task force on practice guidelines. Circulation, 2011, 124(24): e783-831.
2.	Authors/Task members, Elliott PM, Anastasakis A, et al. 2014 ESC guidelines on diagnosis and management of hypertrophic cardiomyopathy: the task force for the diagnosis and management of hypertrophic cardiomyopathy of the european society of cardiology (ESC). Eur Heart J, 2014, 35(39): 2733-2779.
3.	鄒玉寶, 宋雷. 2017中國成人肥厚型心肌病診斷與治療指南精要解讀. 中國分子心臟病學雜志, 2018, 18(2): 2396-2400.
4.	Makavos G, Kairis C, Tselegkidi ME, et al. Hypertrophic cardiomyopathy: an updated review on diagnosis, prognosis, and treatment. Heart Fail Rev, 2019, 24(4): 439-459.
5.	Maron BJ. Clinical course and management of hypertrophic cardiomyopathy. N Engl J Med, 2018, 379(7): 655-668.
6.	Maron BJ, Olivotto I, Bellone P, et al. Clinical profile of stroke in 900 patients with hypertrophic cardiomyopathy. J Am Coll Cardiol, 2002, 39(2): 301-307.
7.	Guttmann OP, Pavlou M, O'Mahony C, et al. Prediction of thrombo-embolic risk in patients with hypertrophic cardiomyopathy (HCM Risk-CVA). Eur J Heart Fail, 2015, 17(8): 837-845.
8.	Haruki S, Minami Y, Hagiwara N. Stroke and embolic events in hypertrophic cardiomyopathy: risk stratification in patients without atrial fibrillation. Stroke, 2016, 47(4): 936-942.
9.	Choi YJ, Choi EK, Han KD, et al. Temporal trends of the prevalence and incidence of atrial fibrillation and stroke among Asian patients with hypertrophic cardiomyopathy: A nationwide population-based study. Int J Cardiol, 2018, 273: 130-135.
10.	Veselka J. Hypertrophic cardiomyopathy is at increased risk of thromboembolic events: deficiencies of CHA 2 DS 2-VASC score and how to predict. Can J Cardiol, 2019, 35(12): 1629-1630.
11.	Lip GY, Nieuwlaat R, Pisters R, et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest, 2010, 137(2): 263-272.
12.	中國老年醫學學會高血壓分會中國高血壓防治指南修訂委員會高血壓聯盟, 中國中華醫學會心血管病學分會, 中國醫師協會高血壓專業委員會. 中國高血壓防治指南( 2018年修訂版). 中國心血管雜志, 2019, 24(1): 24-56.
13.	American Diabetes Association. Standards of medical care in diabetes-2010. Diabetes Care, 2010, 33(Suppl 1): S11- S61.
14.	Sartipy U, Dahlstr?m U, Edner M, et al. Predicting survival in heart failure: validation of the MAGGIC heart failure risk score in 51 043 patients from the Swedish heart failure registry. Eur J Heart Fail, 2014, 16(2): 173-179.
15.	Miyazawa K, Lip GYH. Atrial fibrillation and hypertrophic cardiomyopathy: co-existing conditions with additive risks. Hellenic J Cardiol, 2017, 58(5): 340-341.
16.	吳兆蘇, 姚崇華, 趙冬, 等. 我國人群腦卒中發病率, 死亡率的流行病學研究. 中華流行病學雜志, 2003, (3): 71-74.
17.	Olivotto I, Cecchi F, Casey SA, et al. Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy. Circulation, 2001, 104(21): 2517-2524.
18.	Higashikawa M, Nakamura Y, Yoshida M, et al. Incidence of ischemic strokes in hypertrophic cardiomyopathy is markedly increased if complicated by atrial fibrillation. Jpn Circ J, 1997, 61(8): 673-681.
19.	Guttmann OP, Rahman MS, O'Mahony C, et al. Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy: systematic review. Heart, 2014, 100(6): 465-472.
20.	Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J, 2016, 37(38): 2893-2962.
21.	Siontis KC, Geske JB, Ong K, et al. Atrial fibrillation in hypertrophic cardiomyopathy: prevalence, clinical correlations, and mortality in a large high-risk population. J Am Heart Assoc, 2014, 3(3): e001002.
22.	Camm CF, Camm AJ. Atrial fibrillation and anticoagulation in hypertrophic cardiomyopathy. Arrhythm Electrophysiol Rev, 2017, 6(2): 63-68.
23.	Kannel WB, Wolf PA, Benjamin EJ, et al. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol, 1998, 82(8A): 2N-9N.
24.	Kawasaki T, Sakai C, Harimoto K, et al. Holter monitoring and long-term prognosis in hypertrophic cardiomyopathy. Cardiology, 2012, 122(1): 44-54.

1. Gersh BJ, Maron BJ, Bonow RO, et al. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: a report of the American college of cardiology foundation/American heart association task force on practice guidelines. Circulation, 2011, 124(24): e783-831.
2. Authors/Task members, Elliott PM, Anastasakis A, et al. 2014 ESC guidelines on diagnosis and management of hypertrophic cardiomyopathy: the task force for the diagnosis and management of hypertrophic cardiomyopathy of the european society of cardiology (ESC). Eur Heart J, 2014, 35(39): 2733-2779.
3. 鄒玉寶, 宋雷. 2017中國成人肥厚型心肌病診斷與治療指南精要解讀. 中國分子心臟病學雜志, 2018, 18(2): 2396-2400.
4. Makavos G, Kairis C, Tselegkidi ME, et al. Hypertrophic cardiomyopathy: an updated review on diagnosis, prognosis, and treatment. Heart Fail Rev, 2019, 24(4): 439-459.
5. Maron BJ. Clinical course and management of hypertrophic cardiomyopathy. N Engl J Med, 2018, 379(7): 655-668.
6. Maron BJ, Olivotto I, Bellone P, et al. Clinical profile of stroke in 900 patients with hypertrophic cardiomyopathy. J Am Coll Cardiol, 2002, 39(2): 301-307.
7. Guttmann OP, Pavlou M, O'Mahony C, et al. Prediction of thrombo-embolic risk in patients with hypertrophic cardiomyopathy (HCM Risk-CVA). Eur J Heart Fail, 2015, 17(8): 837-845.
8. Haruki S, Minami Y, Hagiwara N. Stroke and embolic events in hypertrophic cardiomyopathy: risk stratification in patients without atrial fibrillation. Stroke, 2016, 47(4): 936-942.
9. Choi YJ, Choi EK, Han KD, et al. Temporal trends of the prevalence and incidence of atrial fibrillation and stroke among Asian patients with hypertrophic cardiomyopathy: A nationwide population-based study. Int J Cardiol, 2018, 273: 130-135.
10. Veselka J. Hypertrophic cardiomyopathy is at increased risk of thromboembolic events: deficiencies of CHA 2 DS 2-VASC score and how to predict. Can J Cardiol, 2019, 35(12): 1629-1630.
11. Lip GY, Nieuwlaat R, Pisters R, et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest, 2010, 137(2): 263-272.
12. 中國老年醫學學會高血壓分會中國高血壓防治指南修訂委員會高血壓聯盟, 中國中華醫學會心血管病學分會, 中國醫師協會高血壓專業委員會. 中國高血壓防治指南( 2018年修訂版). 中國心血管雜志, 2019, 24(1): 24-56.
13. American Diabetes Association. Standards of medical care in diabetes-2010. Diabetes Care, 2010, 33(Suppl 1): S11- S61.
14. Sartipy U, Dahlstr?m U, Edner M, et al. Predicting survival in heart failure: validation of the MAGGIC heart failure risk score in 51 043 patients from the Swedish heart failure registry. Eur J Heart Fail, 2014, 16(2): 173-179.
15. Miyazawa K, Lip GYH. Atrial fibrillation and hypertrophic cardiomyopathy: co-existing conditions with additive risks. Hellenic J Cardiol, 2017, 58(5): 340-341.
16. 吳兆蘇, 姚崇華, 趙冬, 等. 我國人群腦卒中發病率, 死亡率的流行病學研究. 中華流行病學雜志, 2003, (3): 71-74.
17. Olivotto I, Cecchi F, Casey SA, et al. Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy. Circulation, 2001, 104(21): 2517-2524.
18. Higashikawa M, Nakamura Y, Yoshida M, et al. Incidence of ischemic strokes in hypertrophic cardiomyopathy is markedly increased if complicated by atrial fibrillation. Jpn Circ J, 1997, 61(8): 673-681.
19. Guttmann OP, Rahman MS, O'Mahony C, et al. Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy: systematic review. Heart, 2014, 100(6): 465-472.
20. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J, 2016, 37(38): 2893-2962.
21. Siontis KC, Geske JB, Ong K, et al. Atrial fibrillation in hypertrophic cardiomyopathy: prevalence, clinical correlations, and mortality in a large high-risk population. J Am Heart Assoc, 2014, 3(3): e001002.
22. Camm CF, Camm AJ. Atrial fibrillation and anticoagulation in hypertrophic cardiomyopathy. Arrhythm Electrophysiol Rev, 2017, 6(2): 63-68.
23. Kannel WB, Wolf PA, Benjamin EJ, et al. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol, 1998, 82(8A): 2N-9N.
24. Kawasaki T, Sakai C, Harimoto K, et al. Holter monitoring and long-term prognosis in hypertrophic cardiomyopathy. Cardiology, 2012, 122(1): 44-54.

Chinese Journal of Evidence-Based Medicine

Analysis of the characteristics of thromboembolic events in patients with hypertrophic cardiomyopathy

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