Clinical Profile and Health Disparities in a Multiethnic Cohort of Patients With Hypertrophic Cardiomyopathy

被引:13
作者
Butters, Alexandra [1 ,2 ]
Semsarian, Caitlin R. [3 ]
Bagnall, Richard D. [2 ,3 ]
Yeates, Laura [1 ,2 ,3 ,4 ]
Stafford, Fergus [1 ]
Burns, Charlotte [2 ,3 ,4 ]
Semsarian, Christopher [2 ,3 ,4 ]
Ingles, Jodie [1 ,2 ,4 ]
机构
[1] Univ Sydney, Cardio Genom Program, Centenary Inst, Sydney, NSW, Australia
[2] Univ Sydney, Fac Med & Hlth, Sydney, NSW, Australia
[3] Univ Sydney, Agnes Ginges Ctr Mol Cardiol, Centenary Inst, Sydney, NSW, Australia
[4] Royal Prince Alfred Hosp, Dept Cardiol, Sydney, NSW, Australia
基金
英国医学研究理事会; 澳大利亚国家健康与医学研究理事会;
关键词
atrial fibrillation; ethnic group; genetic testing; healthcare disparities; hypertrophy; hypertrophic cardiomyopathy; IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR; TASK-FORCE; PREVALENCE; GUIDELINES; DIAGNOSIS; FEATURES; DISEASE; GENDER; COMMON; RISK;
D O I
10.1161/CIRCHEARTFAILURE.120.007537
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Clinical studies of hypertrophic cardiomyopathy are over-represented by individuals of European ethnicity, with less known about other ethnic groups. We investigated differences between patients in a multiethnic Australian hypertrophic cardiomyopathy population. Methods: We performed a retrospective cohort study of 836 unrelated hypertrophic cardiomyopathy probands attending a specialized clinic between 2002 and 2020. Major ethnic groups were European (n=611), East Asian (n=75), South Asian (n=58), and Middle Eastern and North African (n=68). The minor ethnicity groups were Oceanian (n=9), People of the Americas (n=7), and African (n=8). One-way ANOVA with Dunnett post hoc test and Bonferroni adjustment were performed. Results: Mean age of the major ethnic groups was 54.9 +/- 16.9 years, and 527 (65%) were male. Using the European group as the control, East Asian patients had a lower body mass index (29 versus 25 kg/m(2), P<0.0001). South Asians had a lower prevalence of atrial fibrillation (10% versus 31%, P=0.024). East Asians were more likely to have apical hypertrophy (23% versus 6%, P<0.0001) and Middle Eastern and North African patients more likely to present with left ventricular outflow tract obstruction (46% versus 34%, P=0.0003). East Asians were less likely to undergo genetic testing (55% versus 85%, P<0.0001) or have an implantable cardioverter-defibrillator implanted (19% versus 36%, P=0.037). East Asians were more likely to have a causative variant in a gene other than MYBPC3 or MYH7, whereas Middle Eastern and North African and South Asians had the highest rates of variants of uncertain significance (27% and 21%, P<0.0001). Conclusions: There are few clinical differences based on ethnicity, but importantly, we identify health disparities relating to access to genetic testing and implantable cardioverter-defibrillator use. Unless addressed, these gaps will likely widen as we move towards precision-medicine-based care of individuals with hypertrophic cardiomyopathy.
引用
收藏
页码:372 / 383
页数:12
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