Prediction of Sudden Cardiac Arrest After Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy: ASA-SCARRE Risk Score

Research output: Contribution to journalJournal articleResearchpeer-review

  • Josef Veselka
  • Max Liebregts
  • Robert Cooper
  • Lothar Faber
  • Jaroslav Januska
  • Maksim Kashtanov
  • Klara Hulikova Tesarkova
  • Hansen, Peter Riis
  • Hubert Seggewiss
  • Eugene Shloydo
  • Kirill Popov
  • Eva Hansvenclova
  • Eva Polakova
  • Jurriën ten Berg
  • Rodney Hilton Stables
  • Jiri Jarkovsky
  • Jiri Bonaventura

This study aimed to derive a new score, the Alcohol Septal Ablation-Sudden Cardiac ARREst (ASA-SCARRE) risk score, that can be easily used to evaluate the risk of sudden cardiac arrest events (sudden cardiac death, resuscitation, or appropriate implantable cardioverter-defibrillator discharge) after alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy. We analyzed 1,834 patients from the Euro-ASA registry (49% men, mean age 57 ± 14 years) who were followed up for 5.0 ± 4.3 years (9,202 patient-years) after ASA. A total of 65 patients (3.5%) experienced sudden cardiac arrest events, translating to 0.72 events per 100 patient-years. The independent predictors of sudden cardiac arrest events were septum thickness before ASA (hazard ratio 1.09 per 1 mm, 95% confidence interval 1.04 to 1.14, p <0.001) and left ventricular outflow tract (LVOT) gradient at the last clinical checkup (hazard ratio 1.01 per 1 mm Hg, 95% confidence interval 1.01 to 1.02, p = 0.002). The following ASA-SCARRE risk scores were derived and independently predicted long-term risk of sudden cardiac arrest events: “0” for both LVOT gradient <30 mmHg and baseline septum thickness <20 mm; “1” for LVOT gradient ≥30 mm Hg or baseline septum thickness ≥20 mm; and “2” for both LVOT gradient ≥30 mm Hg and baseline septum thickness ≥20 mm. The C statistic of the ASA-SCARRE risk score was 0.684 (SE 0.030). In conclusion, the ASA-SCARRE risk score may be a useful and easily available clinical tool to predict risk of sudden cardiac arrest events after ASA in patients with hypertrophic obstructive cardiomyopathy.

Original languageEnglish
JournalAmerican Journal of Cardiology
Volume184
Pages (from-to)120-126
Number of pages7
ISSN0002-9149
DOIs
Publication statusPublished - 2022

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