Modes of death and clinical outcomes in adult patients with hypertrophic cardiomyopathy in Thailand

Abstract

BackgroundThere are limited data about modes of death and major adverse cardiovascular events (MACEs) in patients with hypertrophic cardiomyopathy (HCM) in South East Asian population. The aim of the study was to examine modes of death and clinical outcomes in Thai patients with HCM.MethodsBetween January 1, 2009 and December 31, 2013, 166 consecutive patients with HCM diagnosed in our institution were evaluated. Five patients were excluded because of non-Thai ethnic groups (n = 3) and diagnosis of myocardial infarction at initial presentation documented by coronary angiography (n = 2). The final study population consisted of 161 patients with HCM. HCM-related deaths included: (1) sudden cardiac death (SCD) – death due to sudden cardiac arrest or unexpected sudden death; (2) heart failure – death due to refractory heart failure; or (3) stroke - death due to embolic stroke associated with atrial fibrillation. MACEs included: (1) SCD, sudden unexpected aborted cardiac arrest, fatal, or nonfatal ventricular arrhythmia (ventricular fibrillation or sustained ventricular tachycardia); (2) heart failure (fatal or non-fatal), or heart transplantation; or (3) stroke - fatal or non-fatal embolic stroke associated with atrial fibrillation.ResultsOne hundred and sixty-one Thai patients with HCM (age 66 ± 16 years, 58% female) were enrolled. Forty-two patients (26%) died over a median follow-up period of 6.8 years including 25 patients (16%) with HCM-related deaths (2%/year). The HCM-related deaths included: heart failure (52% of HCM-related deaths; n = 13), SCD (44% of HCM-related deaths; n = 11), and stroke (4% of HCM-related deaths, n = 1). The SCDs occurred in 6.8% of patients (1%/year). Eighty-four major MACEs occurred in 65 patients (41, 5%/year). The MACEs included: 40 heart failures in which 2 patients underwent heart transplants; 22 SCDs and nonfatal ventricular arrhythmias; and 22 fatal or nonfatal strokes.ConclusionsThe most common mode of death in adult patients with HCM in Thailand was heart failure followed by SCD. About one-third of the patients experiencing heart failure died during the 6.8 years of follow-up. SCDs occurred in 7% of patients (1%/year), predominantly in the fourth decade or later.

On Neutrophil Extracellular Trap (NET) Removal: What We Know Thus Far and Why So Little

“…Considering that the half-life of circulating cfDNA is rather short (15–20 min [ 52 ]) its source must be continuous as otherwise such a time window would be too short for its clinical detection. This is in line with the fact that NETs were reported to persist in the vasculature for days [ 53 , 54 , 55 , 56 ], and our preliminary data indicate that this is in fact significantly longer (Santocki and Kolaczkowska, unpublished). Thus, NETs can act as a continuous source of cfDNA and other NET components for over a prolonged period of time.…”

Associations between Dietary Animal and Plant Protein Intake and Cardiometabolic Risk Factors—A Cross-Sectional Study in China Health and Nutrition Survey

“…Results from observational studies have consistently reported positive associations between dietary animal protein intake and risk of type 2 diabetes [ 5 ], coronary heart disease [ 6 , 7 ] and ischemic heart disease [ 8 ] and CVD-specific mortality [ 9 , 10 , 11 ], and inverse associations between dietary plant protein intake and cardiometabolic disorder outcomes [ 5 , 8 , 9 , 10 ]. Although potential mechanisms underpinning these associations have been attributed to the effects of animal or plant protein intake on traditional cardiometabolic risk factors (CMRFs), including lipid and lipoprotein profiles, glucose homeostasis biomarkers and low-grade chronic inflammation, and emerging risk factor serum uric acid or hyperuricemia [ 12 ], data supporting these assumptions are strikingly limited and inconsistent.…”

Germline Genetic Variants of the Renin-Angiotensin System, Hypoxia and Angiogenesis in Non-Small Cell Lung Cancer Progression: Discovery and Validation Studies

“…Fifty-two single nucleotide polymorphisms (SNP) included in the present study from the genes ACE , ACE2 , AGT , AGTR1 , AGTR2 , MME , CMA1 , MAS1 , HIF1A , VEGFA , KDR , PGF and FLT1 ( Table S1 ) were selected from search in genomic public databases, in silico analysis and review of scientific literature, to identify putatively functional polymorphisms [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. Polymorphisms with minor allele frequency below 1% were excluded [ 37 ].…”