Validation of ACC/AHA and ESC Sudden Cardiac Death Risk Guidelines in Diverse Hypertrophic Cardiomyopathy Cohort: Stratification HCM Study

2024

Evaluating Sudden Cardiac Death Risk Guidelines in Brazilian Patients with Hypertrophic Cardiomyopathy

Sample size: 187 publication 10 minutes Evidence: moderate

Author Information

Author(s): Oliveira Antunes Murillo MD, PhD, Fernandes Fabio MD, PhD, Arteaga-Fernandez Edmundo MD, PhD, Alvarez Ramires Félix José MD, PhD, Machado Correia Vinicius MD, Novaes Cardoso Juliano MD, Romero Cristhian Espinoza MD, Sousa Henrique Martins MD, Soliani Marília Taily MD, Dal Piaz Matheus Ramos Ramos MD, Rodrigues Gandarella Anna Danielle MD, Rocha Teixeira Ruiza Gonçalves MD, Mady Charles MD, PhD, Assis Moura Tavares Caio MD, PhD, Guimarães Patricia O. MD, PhD, Madrini Junior Vagner Dr. MD

Primary Institution: Instituto do Coração, Faculdade de Medicina Universidade de São Paulo, São Paulo, Brazil

Hypothesis

The study aims to evaluate the performance of the 2020 ACC/AHA and 2014 ESC guidelines for sudden cardiac death risk stratification in a Brazilian cohort with hypertrophic cardiomyopathy.

Conclusion

The 2020 ACC/AHA and 2014 ESC guidelines have limitations in predicting sudden cardiac death events in Brazilian patients with hypertrophic cardiomyopathy.

Supporting Evidence

The 2020 ACC/AHA guidelines classified 56% of patients as high-risk for sudden cardiac death.
The 2014 ESC guidelines identified 29% of patients as high-risk.
The primary outcome occurred in 12% of the high-risk group identified by the ACC/AHA guidelines.
The primary outcome occurred in 13% of the high-risk group identified by the ESC guidelines.
Both guidelines showed low discriminatory power for sudden cardiac death risk in this cohort.

Takeaway

Doctors used two sets of rules to see who might have a heart problem, but they didn't work well for Brazilian patients with a specific heart condition.

Methodology

This retrospective cohort study included patients diagnosed with hypertrophic cardiomyopathy who were followed in a dedicated clinic at a tertiary hospital in Brazil.