Clinical Profile of Thromboembolic Events in Patients With Hypertrophic Cardiomyopathy in a Regional Japanese Cohort　― Results From Kochi RYOMA Study

• Published in: Circulation Journal 2019/07/25, Vol.83(8), pp.1747-1754
• Main Authors: Hirota, Takayoshi, Kubo, Toru, Baba, Yuichi, Ochi, Yuri, Takahashi, Asa, Yamasaki, Naohito, Hamashige, Naohisa, Yamamoto, Katsuhito, Kondo, Fumiaki, Bando, Kanji, Yamada, Eisuke, Furuno, Takashi, Yabe, Toshikazu, Doi, Yoshinori L., Kitaoka, Hiroaki
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anticoagulants - therapeutic use; Atrial fibrillation; Atrial Fibrillation - diagnosis; Atrial Fibrillation - drug therapy; Atrial Fibrillation - epidemiology; Atrial Fibrillation - mortality; Cardiomyopathy, Hypertrophic - diagnosis; Cardiomyopathy, Hypertrophic - drug therapy; Cardiomyopathy, Hypertrophic - epidemiology; Cardiomyopathy, Hypertrophic - mortality; CHADS2 score; Child; Female; Humans; Hypertrophic cardiomyopathy; Incidence; Japan - epidemiology; Longitudinal Studies; Male; Middle Aged; Prevalence; Prognosis; Registries; Risk Assessment; Risk Factors; Thromboembolic events; Thromboembolism - diagnosis; Thromboembolism - epidemiology; Thromboembolism - mortality; Thromboembolism - prevention & control; Time Factors; Young Adult
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-19-0186

Background:There is limited information about the clinical profiles of patients with hypertrophic cardiomyopathy (HCM) and thromboembolic events in a community-based Japanese patient cohort.Methods and Results:In 2004, we established a cardiomyopathy registration network in Kochi Prefecture that comprised 9 hospitals, and finally 293 patients with HCM were followed. The mean age at registration was 63±14 years, and 197 patients (67%) were men. At registration, 86 patients (29%) had documented atrial fibrillation (AF). During a mean follow-up period of 6.1±3.2 years, thromboembolic events, including 3 embolic stroke deaths, occurred in 23 patients. The 5-year embolic event rate was 5.5%. During the follow-up period, an additional 31 patients (11%) had documentation of AF and finally a total of 117 patients (40%) developed AF. The 5-year embolic event rate in those 117 patients with AF was 12.3%. Of the 23 patients with embolic events, 12 had AF prior to the embolic complications and another 6 had documented AF after thromboembolism. AF was not detected in the remaining 5 patients. The CHADS2score did not correlate with the embolic outcome in HCM patients.Conclusions:In this community-based registry, thromboembolic events were not rare in patients with HCM. All patients with HCM in whom AF develops should be given anticoagulation therapy regardless of their CHADS2score.