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.	邹玉宝, 宋雷. 2017中国成人肥厚型心肌病诊断与治疗指南精要解读. 中国分子心脏病学杂志, 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.	中国老年医学学会高血压分会中国高血压防治指南修订委员会高血压联盟, 中国中华医学会心血管病学分会, 中国医师协会高血压专业委员会. 中国高血压防治指南( 2018年修订版). 中国心血管杂志, 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, Dahlström 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.	吴兆苏, 姚崇华, 赵冬, 等. 我国人群脑卒中发病率, 死亡率的流行病学研究. 中华流行病学杂志, 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. 邹玉宝, 宋雷. 2017中国成人肥厚型心肌病诊断与治疗指南精要解读. 中国分子心脏病学杂志, 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. 中国老年医学学会高血压分会中国高血压防治指南修订委员会高血压联盟, 中国中华医学会心血管病学分会, 中国医师协会高血压专业委员会. 中国高血压防治指南( 2018年修订版). 中国心血管杂志, 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, Dahlström 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. 吴兆苏, 姚崇华, 赵冬, 等. 我国人群脑卒中发病率, 死亡率的流行病学研究. 中华流行病学杂志, 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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