Heart failure & cardiomyopathiesSecondary analysis
Effect of Aficamten vs Metoprolol on Patient-Reported Health Status in Obstructive Hypertrophic Cardiomyopathy
- Secondary analysis of the MAPLE-HCM randomised trial
- double-blind
- international
- head-to-head
Authors' conclusion
Aficamten improved the health status of patients with symptomatic oHCM significantly more than did metoprolol
Study context
- Population
- Adults with symptomatic obstructive hypertrophic cardiomyopathy (KCCQ-CSS ≤90; LV outflow tract obstruction ≥30 mm Hg at rest or ≥50 mm Hg with Valsalva)
- Participants
- 175 adults
- Comparison
- Aficamten vs metoprolol
- Aficamtenn = 88
- Metoprololn = 87reference
- Primary endpoint
- Change in KCCQ Overall Summary Score (OSS)
- Follow-up
- 24 weeks
Primary result
KCCQ-OSS change
Adjusted between-group difference
+7.8 points
95% CI 3.3–12.3
P < 0.001
As reported in the abstract
Further findings
Very large (≥20 points) KCCQ-OSS improvement · 24 weeks
NNT 4.9 (95% CI 3.0–13.9)
Worsening health status (≤−5-point KCCQ-OSS change) · 24 weeks · number needed to harm with metoprolol vs aficamten
NNH 8.6 (95% CI 4.7–53.3)
| Outcome | difference (points) (95% CI) | P value |
|---|---|---|
| SAQ Summary Score change · 24 weeks · nonsignificant | +4.6 (−0.3 to 9.5) | P = 0.063 |
| SAQ Physical Limitation scale change · 24 weeks | +10.1 (3.9–16.2) | P = 0.001 |
Original publication
Effect of Aficamten vs Metoprolol on Patient-Reported Health Status in Obstructive Hypertrophic Cardiomyopathy. J Am Coll Cardiol. Published 18 November 2025. doi:10.1016/j.jacc.2025.10.059
Summarised from the published abstract; every number is checked against it