Risk of ischemic stroke in patients with hypertrophic cardiomyopathy in the absence of atrial fibrillation - a nationwide cohort study

Ting Tse Lin, Yen Ling Sung, Tsung Yu Ko, Chih Kuo Lee, Lian Yu Lin, Jimmy Ji Ming Juang, Cho Kai Wu

Research output: Contribution to journalReview articlepeer-review

17 Citations (Scopus)

Abstract

Ischemic stroke (IS) is a catastrophic complication of hypertrophic cardiomyopathy (HCM) with aging. We investigated the incidence of IS in HCM patients without atrial fibrillation (AF) and compared the relative risk of IS with matched general population with AF. This study identified 17,371 HCM patients without AF and utilized propensity-score-matching to identify one-to-one matched control of general population with AF receiving oral anti-coagulants (OACs). During a median follow-up of 7.3 years, 847 (4.9%) subjects experienced IS with the incidence of 0.589/100 person-years. The corresponding matched controls experienced 788 (4.5%) events with the incidence of 0.494/100 person-years. Compared with control, HCM patients had similar risk of IS (Hazard ratios [HRs] 0.965, 95% confidence interval [CI] 0.854-1.091). HCM patients with age above 65 years had a significantly increased risk of IS (age 65-74 years, HR 1.278, 95% CI 1.070-1.335; age 75 years, HR 1.757, 95% CI 1.435-2.152). Stratified by CHA2DS2-VASc score, HCM subjects with score 0, 1 and 2 had significantly increased risk of IS than control while those with score 2 had similar risk as control. Compared with general population with AF, HCM patients without AF had similar risk of IS, suggesting OACs might be necessary in HCM patient without AF.

Original languageEnglish
Pages (from-to)11347-11357
Number of pages11
JournalAging
Volume11
Issue number23
DOIs
Publication statusPublished - 2019
Externally publishedYes

Keywords

  • Age
  • Hypertrophic cardiomyopathy
  • Risk of ischemic stroke

ASJC Scopus subject areas

  • Ageing
  • Cell Biology

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