Clinical burden of obstructive hypertrophic cardiomyopathy in France
BackgroundHypertrophic cardiomyopathy (HCM) can be genetic and occurs as obstructive and non-obstructive 21 subtypes. Little is known about the clinical burden of the obstructive subtype of HCM at a national 22 level, and how it may differ by New York Heart Association (NYHA) class. Therefore, this...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-01-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1458410/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832591690711433216 |
|---|---|
| author | Philippe Charron Carla Zema François-Emery Cotté Eléonore Herquelot Taryn Krause Florent Daydé Jean-Noël Trochu |
| author_facet | Philippe Charron Carla Zema François-Emery Cotté Eléonore Herquelot Taryn Krause Florent Daydé Jean-Noël Trochu |
| author_sort | Philippe Charron |
| collection | DOAJ |
| description | BackgroundHypertrophic cardiomyopathy (HCM) can be genetic and occurs as obstructive and non-obstructive 21 subtypes. Little is known about the clinical burden of the obstructive subtype of HCM at a national 22 level, and how it may differ by New York Heart Association (NYHA) class. Therefore, this study 23 aimed to describe the clinical burden of patients hospitalized with obstructive HCM from a 24 nationwide study in France.MethodsThis retrospective, longitudinal, observational study was performed using data from the French National Health Data System. All adult patients (≥ 18 years old) with a hospitalization related to obstructive HCM [International Classification of Diseases, Tenth Revision (ICD-10) code I42.1], or at least one hospitalization with ICD-10 code I42.2 or I42.9 and at least one code for septal reduction therapy between 2012 and 2018 were included. Patients were followed up for a minimum of 1 year. NYHA class was assigned using an algorithm based on treatment and symptom codes. Treatment patterns and clinical outcomes by NYHA class over time were examined.ResultsOverall, 6,823 patients with obstructive HCM were included (54.7% male, mean [standard deviation (SD)] age 66.2 [16.7] years). At inclusion, the proportion of patients in NYHA classes I, II, III, and IV were 4%, 32%, 60%, and 4%, respectively. Over the follow-up [mean (SD) follow-up: 4.4 (2.5) years; cumulative patient follow-up: 30,021 patient-years], 73% of patients remained in the same NYHA class, 14% of patients worsened, and 13% improved. At inclusion, 22% of patients had no HCM-related treatment, 56% were receiving β-blockers, 12% calcium-channel blockers, and 11% a combination of both. The incidence of cardiovascular-related hospitalization was high (35,436 hospitalizations; 117,229 per 100,000 patient-years) and this risk increased with NYHA class (from 81,247 per 100,000 patient-years for NYHA class I/II patients to 140,790 per 100,000 patient-years for NYHA class III/IV patients, p < 0.0001).ConclusionsPatients with obstructive HCM are at high risk of death and cardiovascular outcomes, especially those in higher NYHA classes. Despite current therapeutics, the clinical burden of symptomatic obstructive HCM remains high, supporting the need for additional therapies. |
| format | Article |
| id | doaj-art-3b13d1be69c447869adcca3cdbe0c003 |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-3b13d1be69c447869adcca3cdbe0c0032025-01-22T07:11:14ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-01-011110.3389/fcvm.2024.14584101458410Clinical burden of obstructive hypertrophic cardiomyopathy in FrancePhilippe Charron0Carla Zema1François-Emery Cotté2Eléonore Herquelot3Taryn Krause4Florent Daydé5Jean-Noël Trochu6Departments of Genetics and Cardiology, Sorbonne Université, AP-HP, Referral Center for Cardiac Hereditary Diseases, Pitié-Salpêtrière University Hospital, IHU-ICAN, INSERM UMRS_1166, Paris, FranceHealth Economics and Outcomes Research, Bristol Myers Squibb, Princeton, NJ, United StatesHealth Economics and Outcomes Research, Bristol Myers Squibb, Rueil-Malmaison, FranceBiostatistics, Heva, Lyon, FranceHealth Economics and Outcomes Research, Bristol Myers Squibb, Uxbridge, United KingdomBiostatistics, Heva, Lyon, FranceDepartment of Cardiology and Vascular Diseases, Institut du Thorax, University Hospital of Nantes, University of Nantes, CNRS, INSERM, Nantes, FranceBackgroundHypertrophic cardiomyopathy (HCM) can be genetic and occurs as obstructive and non-obstructive 21 subtypes. Little is known about the clinical burden of the obstructive subtype of HCM at a national 22 level, and how it may differ by New York Heart Association (NYHA) class. Therefore, this study 23 aimed to describe the clinical burden of patients hospitalized with obstructive HCM from a 24 nationwide study in France.MethodsThis retrospective, longitudinal, observational study was performed using data from the French National Health Data System. All adult patients (≥ 18 years old) with a hospitalization related to obstructive HCM [International Classification of Diseases, Tenth Revision (ICD-10) code I42.1], or at least one hospitalization with ICD-10 code I42.2 or I42.9 and at least one code for septal reduction therapy between 2012 and 2018 were included. Patients were followed up for a minimum of 1 year. NYHA class was assigned using an algorithm based on treatment and symptom codes. Treatment patterns and clinical outcomes by NYHA class over time were examined.ResultsOverall, 6,823 patients with obstructive HCM were included (54.7% male, mean [standard deviation (SD)] age 66.2 [16.7] years). At inclusion, the proportion of patients in NYHA classes I, II, III, and IV were 4%, 32%, 60%, and 4%, respectively. Over the follow-up [mean (SD) follow-up: 4.4 (2.5) years; cumulative patient follow-up: 30,021 patient-years], 73% of patients remained in the same NYHA class, 14% of patients worsened, and 13% improved. At inclusion, 22% of patients had no HCM-related treatment, 56% were receiving β-blockers, 12% calcium-channel blockers, and 11% a combination of both. The incidence of cardiovascular-related hospitalization was high (35,436 hospitalizations; 117,229 per 100,000 patient-years) and this risk increased with NYHA class (from 81,247 per 100,000 patient-years for NYHA class I/II patients to 140,790 per 100,000 patient-years for NYHA class III/IV patients, p < 0.0001).ConclusionsPatients with obstructive HCM are at high risk of death and cardiovascular outcomes, especially those in higher NYHA classes. Despite current therapeutics, the clinical burden of symptomatic obstructive HCM remains high, supporting the need for additional therapies.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1458410/fullhypertrophic cardiomyopathyepidemiologyNYHAβ-blockerscalcium-channel blockersseptal reduction therapy |
| spellingShingle | Philippe Charron Carla Zema François-Emery Cotté Eléonore Herquelot Taryn Krause Florent Daydé Jean-Noël Trochu Clinical burden of obstructive hypertrophic cardiomyopathy in France Frontiers in Cardiovascular Medicine hypertrophic cardiomyopathy epidemiology NYHA β-blockers calcium-channel blockers septal reduction therapy |
| title | Clinical burden of obstructive hypertrophic cardiomyopathy in France |
| title_full | Clinical burden of obstructive hypertrophic cardiomyopathy in France |
| title_fullStr | Clinical burden of obstructive hypertrophic cardiomyopathy in France |
| title_full_unstemmed | Clinical burden of obstructive hypertrophic cardiomyopathy in France |
| title_short | Clinical burden of obstructive hypertrophic cardiomyopathy in France |
| title_sort | clinical burden of obstructive hypertrophic cardiomyopathy in france |
| topic | hypertrophic cardiomyopathy epidemiology NYHA β-blockers calcium-channel blockers septal reduction therapy |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1458410/full |
| work_keys_str_mv | AT philippecharron clinicalburdenofobstructivehypertrophiccardiomyopathyinfrance AT carlazema clinicalburdenofobstructivehypertrophiccardiomyopathyinfrance AT francoisemerycotte clinicalburdenofobstructivehypertrophiccardiomyopathyinfrance AT eleonoreherquelot clinicalburdenofobstructivehypertrophiccardiomyopathyinfrance AT tarynkrause clinicalburdenofobstructivehypertrophiccardiomyopathyinfrance AT florentdayde clinicalburdenofobstructivehypertrophiccardiomyopathyinfrance AT jeannoeltrochu clinicalburdenofobstructivehypertrophiccardiomyopathyinfrance |