Clinical and economic burden in NYHA class I versus II-IV hypertrophic cardiomyopathy: real-world survey data from the United States of America
P Gebrehiwet, J Jackson, L Hargreaves, S Barlow, L Lebrocq, J Brekke, M Butzner, S Shreay, P DivanjiAbstract
Background
Hypertrophic cardiomyopathy (HCM) is associated with substantial symptoms that can significantly impact quality of life (QoL). However, studies examining the clinical and economic burden of patients with symptomatic vs asymptomatic HCM remain limited.
Objective
To compare the clinical and economic outcomes in patients with HCM and New York Heart Association class I (NYHA 1) vs NYHA II–IV in the United States (US).
Methods
Data were drawn from the Adelphi Real World HCM Disease Specific Programme (DSP™), a multinational, cross-sectional survey conducted between May 2024 and October 2024 in the US. Clinical and economic outcomes were compared between NYHA I and NYHA II–IV groups. Clinical outcomes, including symptoms and cardiovascular (CV) comorbidities, were collected. Healthcare resource utilization (HCRU; ie, hospitalizations, emergency room [ER] visits, day visits, caregiver support) and QoL assessed by EQ-5D-5L and EQ-VAS were measured. Means were reported for utilization and QoL; symptoms and comorbidities with prevalence >5% were summarized as percentages.
Results
Among 701 patients (mean age, 56.27 years; 56.06% were male), 77.60% were NYHA II–IV. Compared with NYHA 1, the NYHA II–IV group had a higher symptom burden, including dyspnea on activity, fatigue/weakness, palpitations, and dizziness (P<0.05 for all) (Table 1). CV comorbidities were also more prevalent in the NYHA II–IV group, including hypertension (49.26% vs 36.31%, P=0.0048), atrial fibrillation/atrial flutter (21.14% vs 8.92%, P=0.0003), left atrial dilation (9.93% vs 9.55%, P=1.0000), and heart failure (11.03% vs 6.37%, P=0.0969). HCRU was higher among the NYHA II–IV group, with more HCM-related hospitalizations (0.11 vs 0.09, P=0.5138), ER visits (0.13 vs 0.04, P=0.0109), day visits (1.25 vs 0.59, P=0.0004), and caregiver support in hours per week (2.62 vs 0.78, P=0.0027). Furthermore, patients with NYHA II–IV vs NYHA 1 reported lower QoL, as measured by EQ-5D-5L and EQ-VAS scores (P<0.05 for both) (Table 2). Notably, despite these differences, patients with NYHA I were still experiencing clinical symptoms and required medical interactions impacting HCRU and QoL.
Conclusions
Over three quarters of US patients with HCM are symptomatic (NYHA II–IV) and experienced substantially greater clinical burden and HCRU compared with NYHA I. These findings highlight an ongoing need for therapies that address the underlying disease mechanisms of HCM to reduce symptoms and improve patient outcomes.For image description, please refer to the figure legend and surrounding text.For image description, please refer to the figure legend and surrounding text.