Comparison of the prognostic usefulness of the European Society of Cardiology and American Heart Association/American College of Cardiology Foundation risk stratification systems in patients with Hypertrophic Cardiomyopathy

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Title: Comparison of the prognostic usefulness of the European Society of Cardiology and American Heart Association/American College of Cardiology Foundation risk stratification systems in patients with Hypertrophic Cardiomyopathy
Author(s): Leong, KMW
Chow, J
Ng, FS
Falaschetti, E
Qureshi, N
Koa-Wing, M
Linton, N
Whinnett, Z
Lefroy, DC
Davies, DW
Lim, PB
Peters, N
Kanagaratnam, P
Varnava, AM
Item Type: Journal Article
Abstract: Implantable cardio-defibrillators (ICDs) have proven benefit in preventing sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HC), making risk stratification essential. Data on the predictive accuracy on the European Society of Cardiology (ESC) risk scoring system has been conflicting. We independently evaluated the ESC risk scoring system in our cohort of HC patients from a large tertiary centre and compared this to previous guidance by the American College of Cardiology Foundation and Heart Association (ACCF/AHA). Risk factor profiles, 5-year SCD risk estimates and ICD recommendations as defined by the ACCF/AHA and ESC guidelines, were retrospectively ascertained for 288 HC patients with and without SCD or equivalent events at our centre. In the SCD group (n=14), a significantly higher proportion of patients would not have met the criteria for an ICD implant using the ESC scoring algorithm than ACCF/AHA guidance (43%vs7%, p=0.029). In those without SCD events (n=274), a larger proportion of individuals not requiring an ICD was identified using the ESC risk score model compared to the ACCF/AHA model (82%vs57%; p<0.0001). Based on risk stratification criteria alone, 5 more individuals with a previously aborted SCD event would not have received an ICD with the ESC risk model than the ACCF/AHA risk model. In conclusion, we found that the current ESC scoring system potentially leaves more high-risk patients unprotected from sudden death in our cohort of patients.
Publication Date: 7-Nov-2017
Date of Acceptance: 26-Oct-2017
URI: http://hdl.handle.net/10044/1/53840
DOI: https://dx.doi.org/10.1016/j.amjcard.2017.10.027
ISSN: 0002-9149
Publisher: Elsevier
Start Page: 349
End Page: 355
Journal / Book Title: American Journal of Cardiology
Volume: 121
Issue: 3
Copyright Statement: © 2017, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor/Funder: Daniel Bagshaw Memorial Trust
British Heart Foundation
Funder's Grant Number: n/a
PG/15/20/31339
Copyright Statement: © 2017, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: 1102 Cardiovascular Medicine And Haematology
Cardiovascular System & Hematology
Publication Status: Published
Appears in Collections:National Heart and Lung Institute
Faculty of Medicine
Epidemiology, Public Health and Primary Care



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