Background: Presently, effective model to predict long-term cardiac mortality in hypertrophic obstructive cardiomyopathy (HOCM) patients is lacking.
Objective: To evaluate predictive value of the modified Age, Creatinine clearance, and Ejection Fraction (mACEF) score for long-term cardiac mortality in HOCM.
Methods: Total 292 patients with HOCM treated non-invasively were enrolled in this study, all of whom with intact medical information.
Results: Over a median follow-up of 41.9 months, 28 cardiac deaths had occurred. In univariate Cox regression analysis, mACEF score was associated with long-term cardiac death (HR=1.795, 95%CI 1.518-2.124, p<0. 001). Multiple Cox regression analysis identified the mACEF score as an independent risk factor of long-term cardiac death (adjusted HR=1.372, 95%CI 1.076-1.749, p=0.011). Analysis of the receiver operating characteristic for long-term cardiac death showed that the mACEF score had a considerable predictive value (AUROC 0.844; sensitivity: 89.29%; specificity: 75.00%) with an optimum cut-off value of 0.96. The total study population was divided into high-risk (mACEF score ≥0.96, n=91) and low-risk (mACEF score<0.96, n=201) groups according to the optimum cut-off value. Kaplan-Meier survival analysis was performed and showed a dramatic higher rate of long-term cardiac mortality in the high-risk group when compared with the low-risk group (27.4% vs. 1.7%,p<0.001 by log-rank test).
Conclusions: The mACEF score has a considerable predictive value for long-term cardiac mortality in HOCM patients treated non-invasively. A mACEF score ≥0.96 could be considered as a sign of poor prognosis in patients with HOCM.