Journal
CURRENT PROBLEMS IN CARDIOLOGY
Volume 48, Issue 11, Pages -Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.cpcardiol.2023.101875
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This study aimed to validate the effectiveness of the 2014 ESC guideline, 2020 AHA/ACC guideline, and 2022 ESC guideline in stratifying the SCD risk of Chinese HCM patients. The results showed that the 2020 AHA/ACC guideline performed better in identifying high-risk groups and had higher sensitivity for SCD risk stratification in Chinese HCM patients than the other two guidelines. The 2014 ESC guideline had lower accuracy.
Accurate identification of hypertrophic car-diomyopathy (HCM) patients at high risk of sudden cardiac death (SCD) event is challenging. The objec-tive of this study was to validate the three SCD risk stratifications recommended by the 2014 European Society of Cardiology (ESC) guideline, the 2020 Amer-ican Heart Association /American College of Cardiol-ogy (AHA/ACC) guideline, and the 2022 ESC guideline in Chinese patients with HCM. Our study population are made up of a cohort of 856 HCM patients without prior SCD events. The endpoint was defined as SCD or equivalent events (successful resuscita-tion after cardiac arrest or appropriate ICD shock for ventricular tachycardia or ventricular fibrillation). Dur-ing a median follow-up of 43 months, SCD endpoints occurred in 44 (5.1%) patients. A total of 34 (77.3%) patients suffering from SCD events were classified cor-rectly into high-risk groups by the 2020 AHA/ACC guideline, 27(61.4%) by the 2022 ESC guideline, and 13 (29.6%) by the 2014 ESC guideline. The C-statistic of the 2020 AHA/ACC guideline was 0.68 (95% CI, 0.60-0.76), which performed better than the 2022 ESC guide-line (0.65: 95% CI, 0.56-0.73), and the 2014 ESC guide-line (0.58: 95% CI, 0.48-0.67). The 2020 AHA/ACC guideline displayed better discrimination for SCD risk stratification in Chinese HCM patients than the other two guidelines, with a higher sensitivity but lower speci-ficity. (Curr Probl Cardiol 2023;48:101875.)
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