Prognosis of Patients with Hypertrophic Obstructive Cardiomyopathy: A Multicenter Cohort Study with Data-Driven Propensity Score Matching Analysis

Background: Hypertrophic obstructive cardiomyopathy (HOCM) patients are reported to have a potential risk of sudden cardiac death (SCD); however, HCM with left ventricular outflow tract (LVOT) obstruction, which is regarded as a risk indicator of SCD, is doubtful since the LVOT gradient is dynamic a...

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Main Authors: Ye He, Huihui Ma, Nian Sun, Shengzhi Zeng, Yanru Zhang, Yan Shu, Wei Hua, Tao Zhou, Ling Zhou, Xiaoping Li
Format: Article
Language:English
Published: IMR Press 2023-09-01
Series:Reviews in Cardiovascular Medicine
Subjects:
Online Access:https://www.imrpress.com/journal/RCM/24/9/10.31083/j.rcm2409267
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author Ye He
Huihui Ma
Nian Sun
Shengzhi Zeng
Yanru Zhang
Yan Shu
Wei Hua
Tao Zhou
Ling Zhou
Xiaoping Li
author_facet Ye He
Huihui Ma
Nian Sun
Shengzhi Zeng
Yanru Zhang
Yan Shu
Wei Hua
Tao Zhou
Ling Zhou
Xiaoping Li
author_sort Ye He
collection DOAJ
description Background: Hypertrophic obstructive cardiomyopathy (HOCM) patients are reported to have a potential risk of sudden cardiac death (SCD); however, HCM with left ventricular outflow tract (LVOT) obstruction, which is regarded as a risk indicator of SCD, is doubtful since the LVOT gradient is dynamic and may be confounded by various environmental factors and routine activities. The purpose of this study was to explore the clinical prognosis of HOCM through a multicenter cohort study with data-driven propensity score matching (PSM) analysis. Methods: The cohort included 2268 patients with HCM from 1996 to 2021 in 13 tertiary hospitals. In the present study, we excluded 458 patients who underwent alcohol septal ablation (ASA) and septal myectomy (SM) surgery so 1810 HCM patients were eventually included. We developed a data-driven propensity score using 24 demographic and clinical variables to create 1:1 propensity-matched cohorts. A Cox proportional hazard regression model was constructed to assess the effect of HOCM on mortality. Results: After logit-matching, there were no significant differences in all-cause mortality (log-rank χ2 = 1.509, p = 0.22), cardiovascular mortality/cardiac transplantation (log-rank χ2 = 0.020, p = 0.89) or SCD (log-rank χ2 = 0.503, p = 0.48) between patients with HOCM and hypertrophic nonobstructive cardiomyopathy (HNCM), and according to the Cox proportional hazard regression model, LVOT obstruction was not a risk predictor in patients with HCM. Conclusions: In both matched and unmatched cohorts, there were no significant differences in clinical prognosis between HOCM and HNCM patients, and LVOT obstruction was not an independent risk predictor of prognosis in patients with HCM. Clinical Trial Registration: ChiCTR1800017330.
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spelling doaj.art-74d301d519ba4be38e358f120e5b0e0b2023-09-27T09:29:52ZengIMR PressReviews in Cardiovascular Medicine1530-65502023-09-0124926710.31083/j.rcm2409267S1530-6550(23)00949-3Prognosis of Patients with Hypertrophic Obstructive Cardiomyopathy: A Multicenter Cohort Study with Data-Driven Propensity Score Matching AnalysisYe He0Huihui Ma1Nian Sun2Shengzhi Zeng3Yanru Zhang4Yan Shu5Wei Hua6Tao Zhou7Ling Zhou8Xiaoping Li9Visual Computing and Virtual Reality Key Laboratory of Sichuan Province, Sichuan Normal University, 610066 Chengdu, Sichuan, ChinaDepartment of Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 610072 Chengdu, Sichuan, ChinaThe First Clinical Institute, Zunyi Medical University, 563000 Zunyi, Guizhou, ChinaDepartment of Cardiology, Guanghan People's Hospital, 618300 Guanghan, Sichuan, ChinaCollege of Computer Science and Engineering, University of Electronic Science and Technology of China, 611731 Chengdu, Sichuan, ChinaDepartment of Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 610072 Chengdu, Sichuan, ChinaCardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037 Beijing, ChinaCollege of Computer Science and Engineering, University of Electronic Science and Technology of China, 611731 Chengdu, Sichuan, ChinaCenter of Statistical Research and School of Statistics, Southwestern University of Finance and Economics, 611130 Chengdu, Sichuan, ChinaDepartment of Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 610072 Chengdu, Sichuan, ChinaBackground: Hypertrophic obstructive cardiomyopathy (HOCM) patients are reported to have a potential risk of sudden cardiac death (SCD); however, HCM with left ventricular outflow tract (LVOT) obstruction, which is regarded as a risk indicator of SCD, is doubtful since the LVOT gradient is dynamic and may be confounded by various environmental factors and routine activities. The purpose of this study was to explore the clinical prognosis of HOCM through a multicenter cohort study with data-driven propensity score matching (PSM) analysis. Methods: The cohort included 2268 patients with HCM from 1996 to 2021 in 13 tertiary hospitals. In the present study, we excluded 458 patients who underwent alcohol septal ablation (ASA) and septal myectomy (SM) surgery so 1810 HCM patients were eventually included. We developed a data-driven propensity score using 24 demographic and clinical variables to create 1:1 propensity-matched cohorts. A Cox proportional hazard regression model was constructed to assess the effect of HOCM on mortality. Results: After logit-matching, there were no significant differences in all-cause mortality (log-rank χ2 = 1.509, p = 0.22), cardiovascular mortality/cardiac transplantation (log-rank χ2 = 0.020, p = 0.89) or SCD (log-rank χ2 = 0.503, p = 0.48) between patients with HOCM and hypertrophic nonobstructive cardiomyopathy (HNCM), and according to the Cox proportional hazard regression model, LVOT obstruction was not a risk predictor in patients with HCM. Conclusions: In both matched and unmatched cohorts, there were no significant differences in clinical prognosis between HOCM and HNCM patients, and LVOT obstruction was not an independent risk predictor of prognosis in patients with HCM. Clinical Trial Registration: ChiCTR1800017330.https://www.imrpress.com/journal/RCM/24/9/10.31083/j.rcm2409267hypertrophic obstruction cardiomyopathyall-cause mortalitycardiovascular mortality/cardiac transplantationsudden cardiac deathdata-driven propensity score matching
spellingShingle Ye He
Huihui Ma
Nian Sun
Shengzhi Zeng
Yanru Zhang
Yan Shu
Wei Hua
Tao Zhou
Ling Zhou
Xiaoping Li
Prognosis of Patients with Hypertrophic Obstructive Cardiomyopathy: A Multicenter Cohort Study with Data-Driven Propensity Score Matching Analysis
Reviews in Cardiovascular Medicine
hypertrophic obstruction cardiomyopathy
all-cause mortality
cardiovascular mortality/cardiac transplantation
sudden cardiac death
data-driven propensity score matching
title Prognosis of Patients with Hypertrophic Obstructive Cardiomyopathy: A Multicenter Cohort Study with Data-Driven Propensity Score Matching Analysis
title_full Prognosis of Patients with Hypertrophic Obstructive Cardiomyopathy: A Multicenter Cohort Study with Data-Driven Propensity Score Matching Analysis
title_fullStr Prognosis of Patients with Hypertrophic Obstructive Cardiomyopathy: A Multicenter Cohort Study with Data-Driven Propensity Score Matching Analysis
title_full_unstemmed Prognosis of Patients with Hypertrophic Obstructive Cardiomyopathy: A Multicenter Cohort Study with Data-Driven Propensity Score Matching Analysis
title_short Prognosis of Patients with Hypertrophic Obstructive Cardiomyopathy: A Multicenter Cohort Study with Data-Driven Propensity Score Matching Analysis
title_sort prognosis of patients with hypertrophic obstructive cardiomyopathy a multicenter cohort study with data driven propensity score matching analysis
topic hypertrophic obstruction cardiomyopathy
all-cause mortality
cardiovascular mortality/cardiac transplantation
sudden cardiac death
data-driven propensity score matching
url https://www.imrpress.com/journal/RCM/24/9/10.31083/j.rcm2409267
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