Sudden Cardiac Death Risk over Time in HCM Patients with Implantable Cardioverter-Defibrillator
Background: In patients with HCM at high risk of SCD, an ICD should be considered as a standard of care. Current risk approximation algorithms recommended by ESC 2014 criteria indicate that SCD risk is not stable. The aim of the study was to investigate how the calculated SCD risk in HCM patients wi...
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| Format: | Article |
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MDPI AG
2022-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/6/1633 |
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| author | Mariusz Klopotowski Krzysztof Kukula Jacek Jamiolkowski Artur Oreziak Maciej Dabrowski Zbigniew Chmielak Adam Witkowski |
| author_facet | Mariusz Klopotowski Krzysztof Kukula Jacek Jamiolkowski Artur Oreziak Maciej Dabrowski Zbigniew Chmielak Adam Witkowski |
| author_sort | Mariusz Klopotowski |
| collection | DOAJ |
| description | Background: In patients with HCM at high risk of SCD, an ICD should be considered as a standard of care. Current risk approximation algorithms recommended by ESC 2014 criteria indicate that SCD risk is not stable. The aim of the study was to investigate how the calculated SCD risk in HCM patients with an ICD implanted in the past changed over time. Methods: We analyzed 64 HCM patients with ICD for primary prevention, referred for ICD re-implantation, and 32 HCM patients referred for a first-time ICD placement during the same period. The 5-year-SCD risk was assessed for suitable patients using the recommended ESC calculator. Results: The first-time group had a higher 5-year-SCD risk than those referred for ICD re-implantation: 7.50 (IQR 5.98–10.46) vs. 4.88 (IQR 3.42–7.25), <i>p</i> < 0.05. Out of the patients with an initial calculated risk below 4%, the risk increased in 22% of cases, reaching the 4–6% range. In 78% of patients, the risk remained stable and low. In 31% of patients with an initial calculated SCD risk ≥ 6%, the risk decreased over time to below 6%, and in 14% of the cases, below 4%. Conclusions: SCD risk in HCM patients is usually stable or gets lower. Our data suggest it is important to re-evaluate the risk profile for patients with HCM when ICD re-implantation is considered. |
| first_indexed | 2024-03-09T19:37:16Z |
| format | Article |
| id | doaj.art-240de38f2191496e8e53a6007467e8f9 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T19:37:16Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-240de38f2191496e8e53a6007467e8f92023-11-24T01:49:45ZengMDPI AGJournal of Clinical Medicine2077-03832022-03-01116163310.3390/jcm11061633Sudden Cardiac Death Risk over Time in HCM Patients with Implantable Cardioverter-DefibrillatorMariusz Klopotowski0Krzysztof Kukula1Jacek Jamiolkowski2Artur Oreziak3Maciej Dabrowski4Zbigniew Chmielak5Adam Witkowski6Department of Interventional Cardiology and Angiology, Cardinal Wyszynski National Institute of Cardiology, 04-628 Warsaw, PolandDepartment of Interventional Cardiology and Angiology, Cardinal Wyszynski National Institute of Cardiology, 04-628 Warsaw, PolandDepartment of Population Medicine and Civilization Disease Prevention, Medical University of Bialystok, 15-269 Bialystok, PolandDepartment of Cardiac Arrhythmias, Cardinal Wyszynski National Institute of Cardiology, 04-628 Warsaw, PolandDepartment of Interventional Cardiology and Angiology, Cardinal Wyszynski National Institute of Cardiology, 04-628 Warsaw, PolandDepartment of Interventional Cardiology and Angiology, Cardinal Wyszynski National Institute of Cardiology, 04-628 Warsaw, PolandDepartment of Interventional Cardiology and Angiology, Cardinal Wyszynski National Institute of Cardiology, 04-628 Warsaw, PolandBackground: In patients with HCM at high risk of SCD, an ICD should be considered as a standard of care. Current risk approximation algorithms recommended by ESC 2014 criteria indicate that SCD risk is not stable. The aim of the study was to investigate how the calculated SCD risk in HCM patients with an ICD implanted in the past changed over time. Methods: We analyzed 64 HCM patients with ICD for primary prevention, referred for ICD re-implantation, and 32 HCM patients referred for a first-time ICD placement during the same period. The 5-year-SCD risk was assessed for suitable patients using the recommended ESC calculator. Results: The first-time group had a higher 5-year-SCD risk than those referred for ICD re-implantation: 7.50 (IQR 5.98–10.46) vs. 4.88 (IQR 3.42–7.25), <i>p</i> < 0.05. Out of the patients with an initial calculated risk below 4%, the risk increased in 22% of cases, reaching the 4–6% range. In 78% of patients, the risk remained stable and low. In 31% of patients with an initial calculated SCD risk ≥ 6%, the risk decreased over time to below 6%, and in 14% of the cases, below 4%. Conclusions: SCD risk in HCM patients is usually stable or gets lower. Our data suggest it is important to re-evaluate the risk profile for patients with HCM when ICD re-implantation is considered.https://www.mdpi.com/2077-0383/11/6/1633hypertrophic cardiomyopathyimplantable cardioverter-defibrillatorsudden cardiac deathrisk |
| spellingShingle | Mariusz Klopotowski Krzysztof Kukula Jacek Jamiolkowski Artur Oreziak Maciej Dabrowski Zbigniew Chmielak Adam Witkowski Sudden Cardiac Death Risk over Time in HCM Patients with Implantable Cardioverter-Defibrillator Journal of Clinical Medicine hypertrophic cardiomyopathy implantable cardioverter-defibrillator sudden cardiac death risk |
| title | Sudden Cardiac Death Risk over Time in HCM Patients with Implantable Cardioverter-Defibrillator |
| title_full | Sudden Cardiac Death Risk over Time in HCM Patients with Implantable Cardioverter-Defibrillator |
| title_fullStr | Sudden Cardiac Death Risk over Time in HCM Patients with Implantable Cardioverter-Defibrillator |
| title_full_unstemmed | Sudden Cardiac Death Risk over Time in HCM Patients with Implantable Cardioverter-Defibrillator |
| title_short | Sudden Cardiac Death Risk over Time in HCM Patients with Implantable Cardioverter-Defibrillator |
| title_sort | sudden cardiac death risk over time in hcm patients with implantable cardioverter defibrillator |
| topic | hypertrophic cardiomyopathy implantable cardioverter-defibrillator sudden cardiac death risk |
| url | https://www.mdpi.com/2077-0383/11/6/1633 |
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