Affiliation:
1. Department of Anesthesiology The Third Hospital of Nanchang, The People’s Hospital of Nanchang Nanchang Jiangxi China
2. Department of Endocrinology The Second Affiliated Hospital of Nanchang University Nanchang Jiangxi China
3. Department of Cardiology Seventh People’s Hospital of Zhengzhou Zhengzhou Henan China
4. Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine OH Cincinnati
5. Department of Cardiology The Second Affiliated Hospital of Nanchang University Jiangxi, China Nanchang
6. Department of Cardiology Sun Yat‐Sen Memorial Hospital of Sun Yat‐sen University Guangzhou Guangdong China
7. Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology Guangzhou Guangdong China
8. Department of Cardiology The First Affiliated Hospital of Sun Yat‐Sen University Guangzhou Guangdong China
Abstract
Background
It is still unclear whether there is a sex difference in the prognosis of patients with hypertrophic cardiomyopathy (HCM). Therefore, we performed a meta‐analysis to elucidate the association between sex and adverse outcomes in patients with HCM.
Methods and Results
The PubMed, Cochrane Library, and Embase databases were used to search for studies on sex differences in prognosis in patients with HCM up to August 17, 2021. Summary effect sizes were calculated using a random effects model. The protocol was registered in PROSPERO (International prospective register of systematic reviews) (registration number‐ CRD42021262053). A total of 27 cohorts involving 42 365 patients with HCM were included. Compared with male subjects, female subjects had a higher age at onset (mean difference=5.61 [95% CI, 4.03–7.19]), a higher left ventricular ejection fraction (standard mean difference=0.09 [95% CI, 0.02–0.15]) and a higher left ventricular outflow tract gradient (standard mean difference=0.23 [95% CI, 0.18–0.29]). The results showed that compared with male subjects with HCM, female subjects had higher risks of HCM‐related events (risk ratio [RR]=1.61 [95% CI, 1.33–1.94],
I
2
=49%), major cardiovascular events (RR=3.59 [95% CI, 2.26–5.71],
I
2
=0%), HCM‐related death (RR=1.57 [95% CI, 1.34–1.82],
I
2
=0%), cardiovascular death (RR=1.55 [95% CI, 1.05–2.28],
I
2
=58%), noncardiovascular death (RR=1.77 [95% CI, 1.46–2.13],
I
2
=0%) and all‐cause mortality (RR=1.43 [95% CI, 1.09–1.87],
I
2
=95%), but not atrial fibrillation (RR=1.13 [95% CI, 0.95–1.35],
I
2
=5%), ventricular arrhythmia (RR=0.88 [95% CI, 0.71–1.10],
I
2
=0%), sudden cardiac death (RR=1.04 [95% CI, 0.75–1.42],
I
2
=38%) or composite end point (RR=1.24 [95% CI, 0.96–1.60],
I
2
=85%).
Conclusions
Based on current evidence, our results show significant sex‐specific differences in the prognosis of HCM. Future guidelines may emphasize the use of a sex‐specific risk assessment for the diagnosis and management of HCM.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine