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Prediction of Sudden Cardiac Arrest After Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy: ASA-SCARRE Risk Score

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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  • Josef Veselka
  • Max Liebregts
  • Robert Cooper
  • Lothar Faber
  • Jaroslav Januska
  • Maksim Kashtanov
  • Klara Hulikova Tesarkova
  • Peter Riis Hansen
  • Hubert Seggewiss
  • Eugene Shloydo
  • Kirill Popov
  • Eva Hansvenclova
  • Eva Polakova
  • Jurriën Ten Berg
  • Rodney Hilton Stables
  • Jiri Jarkovsky
  • Jiri Bonaventura
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This study aimed to derive a new score, the Alcohol Septal Ablation-Sudden Cardiac ARREst (ASA-SCARRE) risk score, that can be easily used to evaluate the risk of sudden cardiac arrest events (sudden cardiac death, resuscitation, or appropriate implantable cardioverter-defibrillator discharge) after alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy. We analyzed 1,834 patients from the Euro-ASA registry (49% men, mean age 57 ± 14 years) who were followed up for 5.0 ± 4.3 years (9,202 patient-years) after ASA. A total of 65 patients (3.5%) experienced sudden cardiac arrest events, translating to 0.72 events per 100 patient-years. The independent predictors of sudden cardiac arrest events were septum thickness before ASA (hazard ratio 1.09 per 1 mm, 95% confidence interval 1.04 to 1.14, p <0.001) and left ventricular outflow tract (LVOT) gradient at the last clinical checkup (hazard ratio 1.01 per 1 mm Hg, 95% confidence interval 1.01 to 1.02, p = 0.002). The following ASA-SCARRE risk scores were derived and independently predicted long-term risk of sudden cardiac arrest events: "0" for both LVOT gradient <30 mmHg and baseline septum thickness <20 mm; "1" for LVOT gradient ≥30 mm Hg or baseline septum thickness ≥20 mm; and "2" for both LVOT gradient ≥30 mm Hg and baseline septum thickness ≥20 mm. The C statistic of the ASA-SCARRE risk score was 0.684 (SE 0.030). In conclusion, the ASA-SCARRE risk score may be a useful and easily available clinical tool to predict risk of sudden cardiac arrest events after ASA in patients with hypertrophic obstructive cardiomyopathy.

OriginalsprogEngelsk
TidsskriftThe American journal of cardiology
Vol/bind184
Sider (fra-til)120-126
Antal sider7
ISSN0002-9149
DOI
StatusUdgivet - 1 dec. 2022

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