Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
BMJ Open. 2022 Mar 9;12(3):e058151. doi: 10.1136/bmjopen-2021-058151.
To evaluate sex differences in demographic and clinical characteristics, treatments and outcomes for patients with diagnosed obstructive hypertrophic cardiomyopathy (oHCM) in the USA.
Retrospective observational study of administrative claims data from MarketScan Commercial Claims and Encounters Database from IBM Watson Health.
Of the 28 million covered employees and family members in MarketScan, 9306 patients with oHCM were included in this analysis.
oHCM-related outcomes included heart failure, atrial fibrillation, ventricular tachycardia/ fibrillation, sudden cardiac death, septal myectomy, alcohol septal ablation (ASA) and heart transplant.
Among 9306 patients with oHCM, the majority were male (60.5%, p<0.001) and women were of comparable age to men (50±15 vs 49±15 years, p<0.001). Women were less likely to be prescribed beta blockers (42.7% vs 45.2%, p=0.017) and undergo an implantable cardioverter-defibrillator (1.7% vs 2.6%, p=0.005). Septal reduction therapy was performed slightly more frequently in women (ASA: 0.08% vs 0.05%, p=0.600; SM: 0.35% vs 0.18%, p=0.096), although not statistically significant. Women were less likely to have atrial fibrillation (6.7% vs 9.9%, p<0.001).
Women were less likely to be prescribed beta blockers, ACE inhibitors, anticoagulants, undergo implantable cardioverter-defibrillator and have ventricular tachycardia/fibrillation. Men were more likely to have atrial fibrillation. Future research using large, clinical real-world data are warranted to understand the root cause of these potential treatment disparities in women with oHCM.
评估美国诊断为梗阻性肥厚型心肌病（oHCM）患者的人口统计学和临床特征、治疗方法和结局的性别差异。
回顾性观察性研究，使用 IBM Watson Health 的 MarketScan 商业索赔和就诊数据库中的行政索赔数据。
在 MarketScan 覆盖的 2800 万员工及其家属中，有 9306 名 oHCM 患者纳入本分析。
oHCM 相关结局包括心力衰竭、心房颤动、室性心动过速/颤动、心脏性猝死、室间隔心肌切除术、酒精室间隔消融术（ASA）和心脏移植。
在 9306 名 oHCM 患者中，大多数为男性（60.5%，p<0.001），女性与男性年龄相仿（50±15 岁比 49±15 岁，p<0.001）。女性更不可能被处方β受体阻滞剂（42.7%比 45.2%，p=0.017）和植入式心脏复律除颤器（1.7%比 2.6%，p=0.005）。女性行间隔缩减治疗的频率略高（ASA：0.08%比 0.05%，p=0.600；SM：0.35%比 0.18%，p=0.096），但无统计学意义。女性心房颤动的发生率更低（6.7%比 9.9%，p<0.001）。
女性更不可能被处方β受体阻滞剂、血管紧张素转换酶抑制剂、抗凝剂、植入式心脏复律除颤器，且发生室性心动过速/颤动的风险较低。男性更可能发生心房颤动。未来需要使用大型临床真实世界数据进行研究，以了解 oHCM 女性潜在治疗差异的根本原因。
