Heart failure & cardiomyopathiesCohort study
Long-Term Impact of Frailty on Outcomes Following Alcohol Septal Ablation in Hypertrophic Obstructive Cardiomyopathy
- Propensity-score matched cohort study
- United States Collaborative Network (2005-2025)
- Propensity-score matching (1:1)
Authors' conclusion
Frail patients undergoing ASA for HOCM exhibit higher risks of long-term mortality and adverse clinical outcomes compared with their nonfrail counterparts.
Study context
- Population
- Patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing alcohol septal ablation (ASA), stratified into frail and nonfrail groups by the Johns Hopkins Adjusted Clinical Group frailty-defining diagnosispatients undergoing ASA, 2,264 (5.8%) were frail, 2,219 patients matched per group
- Participants
- 39,063 patients
- Exposure
- Frail vs nonfrail patients undergoing ASA
- Frailn = 2,219
- Nonfrailn = 2,219reference
- Outcome
- All-cause mortality
- Follow-up
- 10 years
Main finding
As reported in the abstract
Hazard ratio
1.40
95% CI 1.26–1.55
P < 0.001
Frail vs Nonfrail
HR 1.40 (95% CI 1.26–1.55); P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Major adverse cardiac and cerebrovascular event · 1-year post-ASA | 1.49 (1.30–1.70) | P < 0.001 | |
| Ischemic stroke · 1-year post-ASA | 1.57 (1.24–2.00) | P < 0.001 | |
| Heart failure exacerbation · 1-year post-ASA | 1.09 (1.01–1.19) | P = 0.024 | |
| All-cause readmission · 1-year post-ASA | 1.33 (1.24–1.43) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
Acute myocardial infarction, sudden cardiac arrest, antiarrhythmic drugs initiation/escalation, electrical cardioversion
- No differences were noted
Safety
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Major bleeding · 1-year post-ASA | 1.61 (1.38–1.88) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
Original publication
Long-Term Impact of Frailty on Outcomes Following Alcohol Septal Ablation in Hypertrophic Obstructive Cardiomyopathy. JACC Adv. Published 28 April 2026. doi:10.1016/j.jacadv.2026.102767
Summarised from the published abstract; every number is checked against it