Validation of the new American College of Cardiology/American Heart Association Guidelines for the risk stratification of sudden cardiac death in a large Mediterranean cohort with Hypertrophic Cardiomyopathy.

Autor:	Zegkos T; Clinic of Cardiomyopathies and Inherited Cardiac Diseases, First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece. Electronic address: zegkosth@gmail.com., Tziomalos G; Clinic of Cardiomyopathies and Inherited Cardiac Diseases, First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece., Parcharidou D; Clinic of Cardiomyopathies and Inherited Cardiac Diseases, First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece., Ntelios D; Clinic of Cardiomyopathies and Inherited Cardiac Diseases, First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece., Papanastasiou CA; Clinic of Cardiomyopathies and Inherited Cardiac Diseases, First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece., Karagiannidis E; Clinic of Cardiomyopathies and Inherited Cardiac Diseases, First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece., Gossios T; Clinic of Cardiomyopathies and Inherited Cardiac Diseases, First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece., Rouskas P; Clinic of Cardiomyopathies and Inherited Cardiac Diseases, First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece., Katranas S; Clinic of Cardiomyopathies and Inherited Cardiac Diseases, First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece., Paraskevaidis S; Clinic of Cardiomyopathies and Inherited Cardiac Diseases, First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece., Karvounis H; Clinic of Cardiomyopathies and Inherited Cardiac Diseases, First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece., Efthimiadis G; Clinic of Cardiomyopathies and Inherited Cardiac Diseases, First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece.
Jazyk:	angličtina
Zdroj:	Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese [Hellenic J Cardiol] 2022 Jan-Feb; Vol. 63, pp. 15-21. Date of Electronic Publication: 2021 Jun 17.
DOI:	10.1016/j.hjc.2021.06.005
Abstrakt:	Background: The aim of our study was to assess the performance of the new American College of Cardiology (ACC)/American Heart Association (AHA) Guidelines, with respect to sudden cardiac death (SCD) prevention, in comparison with the established risk score of the European Society of Cardiology (hypertrophic cardiomyopathy [HCM] Risk-SCD), in a large Mediterranean cohort of HCM patients. Methods: The clinical and imaging characteristics of 784 HCM patients (mean age at first evaluation 52 ± 16 years, 67.2% males) were analyzed retrospectively. The sensitivity, specificity, and negative predictive value for SCD events of the presence of ≥1 risk factor for SCD according to the ACC/AHA Guidelines 2020 and of the HCM Risk-SCD≥6% and HCM Risk-SCD≥4% were estimated during follow-up. Results: During follow-up, 47 (6%) patients suffered an SCD event. The presence of ≥1 major risk factor for SCD according to the new ACC/AHA Guidelines had 96% sensitivity (95% CI 85.5-99.5%) with modest specificity of 59% (95% CI 55-62.2%) and negative predictive value of 99.5% (95% CI 98.2-99.9%). On the contrary, HCM- Risk-SCD≥6% had a relatively low sensitivity (32%, 95% CI 19.1-47.1%) and high specificity of 95% (95% CI 93.1-96.4%), whereas, HCM-Risk-SCD≥4% had sensitivity of 60% (95% CI 44-74%) and specificity of 83.9% (95% CI 80-85.6%). Both the HCM Risk-SCD cut-off values demonstrated lower negative predictive value but higher accuracy than the ACC/AHA algorithm for SCD prediction. Conclusion: The novel ACC/AHA proposed algorithm identifies most of the patients with an SCD event with the cost of numerous defibrillator implantations. HCM-Risk-SCD demonstrated higher specificity, whereas its sensitivity and negative predictive value are modest. Competing Interests: Conflict of interest None declared by all authors. (Copyright © 2021 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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