Long-term survival after acute myocardial infarction in patients with hypertrophic cardiomyopathy

Clin Cardiol. 2017 Jan;40(1):26-31. doi: 10.1002/clc.22601. Epub 2016 Oct 17.

Abstract

Background: Hypertrophic cardiomyopathy (HCM) is associated with poor prognosis. It has been reported that there is no difference in in-hospital mortality after acute myocardial infarction (AMI) between patients with and without HCM. However, whether there is a difference in long-term survival after AMI between patients with and without HCM remains unclear.

Hypothesis: Long-term survival after AMI is worse in patients with vs without HCM.

Methods: The clinical profiles of 91 consecutive patients with HCM and AMI (HCM group) and 91 sex- and age-matched patients with AMI without HCM (non-HCM group) were analyzed. The study endpoint was all-cause mortality.

Results: During a follow-up period of 4.9 ± 3.6 years, all-cause mortality occurred in 25 patients (27.5%) in the HCM group and 13 patients (14.3%) in the non-HCM group. The survival of the HCM group was inferior to that of the non-HCM group (log-rank P = 0.039). During the first year of follow-up, 3 deaths (3.3%) occurred in the HCM group and 7 deaths (7.7%) occurred in the non-HCM group (log-rank P = 0.177). Among patients who survived beyond the first year of follow-up (172 patients), the annual mortality rates were 6.3% (95% confidence interval: 4.0%-9.3%) in the HCM group and 1.6% (95% confidence interval: 0.6%-3.5%) in the non-HCM group (log-rank P = 0.001).

Conclusions: AMI patients with HCM exhibited worse long-term survival than did AMI patients without HCM.

Keywords: acute myocardial infarction; hypertrophic cardiomyopathy; survival.

MeSH terms

  • Age Factors
  • Cardiomyopathy, Hypertrophic / complications*
  • Cardiomyopathy, Hypertrophic / mortality
  • China / epidemiology
  • Female
  • Follow-Up Studies
  • Hospital Mortality / trends
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Myocardial Infarction / mortality*
  • Prognosis
  • Retrospective Studies
  • Survival Rate / trends
  • Time Factors