Survival after alcohol septal ablation versus conservative therapy in obstructive hypertrophic cardiomyopathy
| Autor: | Chaomei Fan, Yishi Li, Shubin Qiao, Fenghuan Hu, Yinjian Yang, Xiying Guo, Jinqing Yuan |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Ablation Techniques
Male China Alcohol septal ablation medicine.medical_specialty Kaplan-Meier Estimate Ventricular Septum Injections Intralesional Ventricular Outflow Obstruction Risk Factors Internal medicine Heart Septum Clinical endpoint Humans Medicine Hospital Mortality Survival rate Retrospective Studies Ethanol business.industry Hazard ratio Retrospective cohort study General Medicine Middle Aged Heart septum Confidence interval Survival Rate Treatment Outcome Cohort Solvents Cardiology Female Hypertrophy Left Ventricular Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Cardiology Journal. 22:657-664 |
| ISSN: | 1898-018X 1897-5593 |
| DOI: | 10.5603/cj.a2015.0032 |
| Popis: | Background: The impact of alcohol septal ablation (ASA) on the survival of patients with drug-refractory obstructive hypertrophic cardiomyopathy (HCM) remains unresolved. The aim of this study was to compare survival after ASA vs. conservative therapy. Methods: We studied a consecutive cohort of 274 patients with severe drug-refractory obstructive HCM, 229 in ASA group and 45 in conservative group. The primary endpoint was a composite of all-cause mortality and aborted cardiac arrest. Results: With a median follow-up of 4.3 years, primary endpoint occurred in 13 (5.7%) patients in the ASA group, and 8 (17.8%) patients in the conservative group. The 5- and 10-year survival free from primary endpoint of the ASA group (94.5% and 93.0%, respectively) was significantly better than that of the conservative group (78.3% and 72.2%, respectively, log-rank p = 0.009). Independent determinants of primary endpoint were ASA therapy (hazard ratio [HR] 0.22; 95% confidence interval [CI] 0.08–0.60; p = 0.003) and maximal septal thickness (HR 1.14; 95% CI 1.03–1.27; p = 0.011). Conclusions: In patients with severe drug-refractory obstructive HCM, survival after ASA is favorable and better than that of conservative therapy. ASA seems to improve survival. |
| Databáze: | OpenAIRE |
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