Presentation (CTI)

OBJECTIVES: Patients with obstructive hypertrophic cardiomyopathy (HCM) experience progressively worsening symptoms and reduced exercise capacity. In patients with severe obstructive HCM refractory to maximal standard medical therapy, septal reduction therapy is a treatment option recommended by the Brazilian guidelines. However, there are limited data evaluating patient access to septal myectomy (SM) treatment in the Brazilian public healthcare system (SUS). This study investigates the number of SM procedures performed to treat obstructive HCM and the characteristics of patients.
METHODS: A retrospective database study was conducted from SUS perspective using claim data from the government information system, from 2015 to 2024. All septal myectomy (SM) procedures (0406010323) and cases of obstructive HCM (ICD-10 I42.1) were identified. Results will be described as measures of central tendency (means, medians) and spread (variance, range) for continuous variables and absolute number and percentage for categorical variables.
RESULTS: The total number of patients diagnosed with obstructive HCM in the SUS in the study period was 1,379, of which 46% were male (n=639) with a mean age of 50.11 ± 20.80 years. A total of 209 SM (15.16% of patients) were performed at SUS from 2015 to 2024 which 62% of the patients being male and a mean age of 51.85 ± 14.64 years. The average outpatient cost and SM cost during the analysed period were (BRL) R$ 116.93 and R$ 16,484.48, respectively, with a mortality rate of 8.1% (17/209).
CONCLUSIONS: The real-world study using data from SUS, demonstrated that SM is performed for only a small proportion of patients. The reasons for this limited utilisation need to be further investigated and may be attributed to a combination of factors such as guideline ineligibility, contraindications, patient preferences, variation in clinical practice and limited access to experienced centers and surgeons. Study funded by Bristol Myers Squibb, São Paulo - SP, Brazil.