Risk of Atrial Fibrillation and Stroke in Patients with Hypertrophic Obstructive Cardiomyopathy Treated by Modified Morrow Septal Myectomy: Reports of a Propensity Score Matching Cohort.

IF 2.3 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Yi-Xi Zou, Xi-Lin Zhang, Jian-Peng Zheng, Feng Lu, Gregory Y H Lip, Ying Bai, Yu-Feng Sun, Wei-Hua Guo
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引用次数: 0

Abstract

Background: A modified Morrow septal myectomy (MMSM) is one of the main treatment methods for obstructive hypertrophic cardiomyopathy (OHCM). Our aim was to study the impact of MMSM on the risk of AF and stroke in OHCM patients.

Methods and results: From 1 January 2014 to 31 December 2020, 6426 patients with obstructive HCM (OHCM) were selected from the Beijing Municipal Health Commission Information Center (BMHCIC) datasets (mean age: 54.3 years; 43.8% female). After propensity score matching, 3780 patients were selected, including 1890 who received MMSM (Group 1) and 1890 who did not receive any surgery (Group 2). During a median of 0.8 (interquartile range [IQR]: 0.1, 2.7) years of follow-up after discharge from the hospital, stroke risk was lower in Group 1 compared to Group 2 (aHR: 0.4, 95%CI: 0.2-0.6, p < 0.001), and the results were further confirmed by Kaplan-Meier analyses (p < 0.001). There was no statistically significant difference in the risk of AF (aHR: 1.0, 95%CI: 0.7-1.5, p = 0.991). The risk of AF decreased in the first 6 years since receiving MMSM and then sharply increased beyond 6 years after MMSM according to Kaplan-Meier analyses.

Conclusions: MMSM is associated with a decreased risk of stroke in OHCM patients. The risk of AF decreased in the first 6 years since receiving MMSM and then sharply increased beyond 6 years after MMSM.

改良Morrow隔肌切除术治疗肥厚性梗阻性心肌病患者心房颤动和卒中的风险:倾向评分匹配队列报告
背景:改良Morrow隔肌切除术(MMSM)是梗阻性肥厚性心肌病(OHCM)的主要治疗方法之一。我们的目的是研究MMSM对OHCM患者房颤和卒中风险的影响。方法与结果:2014年1月1日至2020年12月31日,从北京市卫生健康委员会信息中心(BMHCIC)数据集中选择6426例梗阻性HCM (OHCM)患者,平均年龄54.3岁,女性43.8%。倾向评分匹配后,选择3780例患者,其中接受MMSM的患者1890例(第一组)和未接受任何手术的患者1890例(第二组)。出院后随访中位数为0.8年(四分位数间距[IQR]: 0.1, 2.7), 1组卒中风险低于2组(aHR: 0.4, 95%CI: 0.2-0.6, p < 0.001), Kaplan-Meier分析进一步证实了这一结果(p < 0.001)。两组患者发生房颤的风险差异无统计学意义(aHR: 1.0, 95%CI: 0.7 ~ 1.5, p = 0.991)。Kaplan-Meier分析显示,在接受MMSM后的前6年,房颤风险下降,6年后,房颤风险急剧上升。结论:MMSM与OHCM患者卒中风险降低相关。在接受MMSM后的前6年,房颤的风险下降,而在接受MMSM后的6年后,房颤的风险急剧上升。
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来源期刊
Journal of Cardiovascular Development and Disease
Journal of Cardiovascular Development and Disease CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.60
自引率
12.50%
发文量
381
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