Gender Differences in Periprocedural and Long-term Outcomes in Patients with Hypertrophic Cardiomyopathy Treated with Alcohol Septal Ablation Therapy: A Single Center Retrospective Study

Abstract

Background and Aim:We aim to demonstrate the periprocedural and long-term results of alcohol septal ablation (ASA) treatment in patients with hypertrophic cardiomyopathy (HCM) and specify the differences between female and male patients.Materials and Methods:We enrolled 53 consecutive patients with HCM who underwent ASA treatment. Preprocedural demographic data, pre-and postprocedural characteristics and complications, echocardiographic data, and long-term results, including all-cause mortality and major adverse cardiovascular events (MACE), were recorded. MACE was defined as sudden cardiac death due to ventricular arrhythmias or heart failure (HF) and rehospitalizations due to HF or atrial fibrillation after the procedure.Results:The mean age was 56.4 ± 12.1 years and 29 (54.7%) of the patients were female. Age at the time of ablation was higher (P = 0.04), and the presentation New York Heart Association functional class (P = 0.03) was worse in female patients. The median volume of ethanol usage was higher in male patients (P = 0.03) and the median duration of intensive care unit stay was higher in female patients (P = 0.02). The overall survival rates after ASA at 1, 5, 10, and 12 years were 96%, 87%, 76%, and 76%, respectively. There was no difference in the overall survival rates between genders (log-rank P = 0.4) and MACE was significantly higher in women patients (log-rank P = 0.03).Conclusion:Women patients with HCM were older and had a worse functional capacity during the ASA procedure. Despite the similar mortality rates between genders, MACE was higher in women after the procedure. Earlier evaluation and treatment in female patients might decrease MACE during follow-up after ASA treatment.

Keywords

• gender differences
• sex differences
• hypertrophic cardiomyopathy
• alcohol septal ablation
• mortality
• major adverse cardiovascular events