Septal reduction therapy (SRT) -i.e. septal myectomy and alcohol septal ablation-has been performed to treat medically refractory hypertrophic cardiomyopathy (HCM) for decades. However, it is largely unknown whether SRT prevents HCM-related cardiovascular events or death. The objective was to examine the effects of SRT on acute cardiovascular events and all-cause mortality in HCM. We performed a propensity score (PS) -matched study using databases that capture all hospitalizations and outpatient visits in New York state. We identified patients with HCM who underwent SRT between 2007 and 2014 (i.e. the SRT group) and those who had never had SRT but had at least one hospitalization for HCM during the same period (i.e. the control group). We performed PS matching at a 1:1 ratio. The primary outcome was a composite of acute cardiovascular events and all-cause mortality during 0-180 days and 181-360 days. The secondary outcome was 180- and 360-day all-cause mortality. We included 846 patients with HCM (423 PS-matched pairs). Patients who underwent SRT had a lower risk of the primary outcome event (0-180 days: odds ratio [OR], 0.54; 95% confidence intervals (CI), 0.37-0.80; P = 0.002 and 181-360 days: OR, 0.33; 95% CI, 0.22-0.51; P < 0.0001). Furthermore, the risk of all-cause mortality was lower at 180 days (OR, 0.37; 95% CI, 0.22-0.63; P = 0.0003) and 360 days post-SRT (OR, 0.32; 95% CI, 0.20-0.51; P < 0.0001). In conclusion, our PS-matched study using population-based datasets demonstrated that SRT was associated with a reduced risk of a composite of acute cardiovascular events and all-cause mortality in HCM during the first post-SRT year.

几十年来，室间隔复位疗法 (SRT) - 即室间隔肌切除术和酒精性室间隔消融 - 已用于治疗难治性肥厚型心肌病 (HCM)。然而，SRT 是否能预防 HCM 相关的心血管事件或死亡在很大程度上是未知的。目的是检查 SRT 对 HCM 急性心血管事件和全因死亡率的影响。我们使用获取纽约州所有住院和门诊就诊的数据库进行了一项倾向评分 (PS) 匹配研究。我们确定了 2007 年至 2014 年间接受 SRT 的 HCM 患者（即 SRT 组）和那些从未接受过 SRT 但在同一时期至少因 HCM 住院过一次的患者（即对照组）。我们以 1:1 的比例进行 PS 匹配。主要结果是 0-180 天和 181-360 天期间急性心血管事件和全因死亡率的复合结果。次要结果是 180 天和 360 天的全因死亡率。我们纳入了 846 名 HCM 患者（423 对 PS 匹配）。接受 SRT 的患者发生主要结局事件的风险较低（0-180 天：优势比 [OR]，0.54；95% 置信区间 (CI)，0.37-0.80；P = 0.002 和 181-360 天：OR，0.33；95% CI，0.22-0.51；P < 0.0001)。此外，SRT 后180 天（OR，0.37；95% CI，0.22-0.63；P = 0.0003）和 360 天（OR，0.32；95% CI，0.20-0.51；P < 0.0001)。总之，我们使用基于人群的数据集的 PS 匹配研究表明，在 SRT 后的第一年，SRT 与 HCM 急性心血管事件和全因死亡率复合风险的降低相关。