Heart failure & cardiomyopathiesCohort study

Genotype and Family History as Risk Markers of Sudden Cardiac Death in Hypertrophic Cardiomyopathy

JACC Clin ElectrophysiolPublished

  • historical cohort study
  • registries of 2 hypertrophic cardiomyopathy (HCM) referral centers
  • multivariable hazard regression analysis

Authors' conclusion

FHxSCD remained independently associated with SCD in adult patients with HCM even after adjusting for genotype. Among patients with FHxSCD but no other risk markers, genotype-positive patients were at high risk of SCD but genotype-negative patients were not. These data suggest that ICD insertion is not indicated for most genotype-negative patients with FHxSCD unless other risk markers are present.

Study context

Population
Patients with hypertrophic cardiomyopathy (HCM) at 2 HCM referral centers896 (27.5%) genotype-positive, 332 (10.2%) with FHxSCD
Participants
3,258 patients
Exposure
Association of FHxSCD and genotype with sudden cardiac death (SCD)
  • FHxSCDn = 332
  • genotype-positiven = 896

Main finding

As reported in the abstract

SCD outcome · 4.9 years' median follow-up
multivariable analysis
Hazard ratio (95% CI)P value
FHxSCD
1.83(1.161–2.9)
P = 0.01
genotype-positive
1.52(1.01–2.31)
P = 0.047
patients reaching the SCD outcome
114

Observational data: associations, not effects.

Further findings

Outcomegenotype-positive patients with FHxSCD but no other risk markersgenotype-negative patients with FHxSCD but no other risk markers
Risk of SCD events among patients with FHxSCD but no other risk markers · 5 years6.4% (95% CI 2.7%–14.9%)2.6% (95% CI 0.6%–10.0%)

Original publication

Genotype and Family History as Risk Markers of Sudden Cardiac Death in Hypertrophic Cardiomyopathy. JACC Clin Electrophysiol. Published 5 March 2026. doi:10.1016/j.jacep.2026.01.033

Summarised from the published abstract; every number is checked against it