Umeå University's logo

umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Alcohol Septal Ablation versus Septal Myectomy Treatment of Obstructive Hypertrophic Cardiomyopathy: A Systematic Review and Meta-Analysis
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Universi College, Bardhosh, Prishtina, Kosovo; Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo.ORCID iD: 0000-0002-8996-4257
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Molecular and Clinic Research Institute, St George University, Brunel University, London, UK; Institute of Fluid Dynamics, Brunel University, London, UK.ORCID iD: 0000-0002-6089-5614
2020 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 9, no 10, article id 3062Article, review/survey (Refereed) Published
Abstract [en]

Surgical myectomy (SM) and alcohol septal ablation (ASA) are two invasive therapies for symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM), despite medical therapy. This meta-analysis aims to compare the efficacy of the two procedures. We searched all electronic databases until February 2020 for clinical trials and cohorts comparing clinical outcomes of ASA and SM treatment of patients with HOCM. The primary endpoint was all-cause mortality, cardiovascular (CV) mortality, sudden cardiac death (SCD), re-intervention, and complications. Secondary endpoints included relief of clinical symptoms and drop of left ventricular outflow tract (LVOT) gradient. Twenty studies (4547 patients; 2 CTs and 18 cohorts) comparing ASA vs. SM with a mean follow-up of 47 ± 28.7 months were included. Long term (8.72 vs. 7.84%, p = 0.42) and short term (1.12 vs. 1.27%, p = 0.93) all-cause mortality, CV mortality (2.48 vs. 3.66%, p = 0.26), SCD (1.78 vs. 0.76%, p = 0.20) and stroke (0.36 vs. 1.01%, p = 0.64) were not different between procedures. ASA was associated with lower peri-procedural complications (5.57 vs. 10.5%, p = 0.04) but higher rate of re-interventions (10.1 vs. 0.27%; p < 0.001) and pacemaker dependency (12.4 vs. 4.31%, p = 0.0004) compared to SM. ASA resulted in less reduction in LVOT gradient (−47.8 vs. −58.4 mmHg, p = 0.01) and less improvement of clinical symptoms compared to SM (New York Heart Association (NYHA) class III/IV, 82.4 vs. 94.5%, p < 0.001, angina 53.2 vs. 84.2%, p = 0.02). Thus, ASA and SM treatment of HOCM carry a similar risk of mortality. Peri-procedural complications are less in alcohol ablation but re-intervention and pacemaker implantations are more common. These results might impact the procedure choice in individual patients, for the best clinical outcome.

Place, publisher, year, edition, pages
MDPI, 2020. Vol. 9, no 10, article id 3062
Keywords [en]
hypertrophic obstructive cardiomyopathy, alcohol septal ablation, septal myectomy
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-177064DOI: 10.3390/jcm9103062ISI: 000586898300001PubMedID: 32977442Scopus ID: 2-s2.0-85105718265OAI: oai:DiVA.org:umu-177064DiVA, id: diva2:1506744
Available from: 2020-12-04 Created: 2020-12-04 Last updated: 2023-03-24Bibliographically approved

Open Access in DiVA

fulltext(6450 kB)235 downloads
File information
File name FULLTEXT01.pdfFile size 6450 kBChecksum SHA-512
0330515b351b95fae71f6cbaee2ac4ddc6fa60d44bf0d55a44515dc1a336de02a1663e9020d3f10457a1ea0783ea92e54e51934cba871be59de7892b01e8f8ca
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records

Bytyci, IbadeteMörner, StellanHenein, Michael Y.

Search in DiVA

By author/editor
Bytyci, IbadeteMörner, StellanHenein, Michael Y.
By organisation
Cardiology
In the same journal
Journal of Clinical Medicine
Cardiac and Cardiovascular Systems

Search outside of DiVA

GoogleGoogle Scholar
Total: 235 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 243 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf