Prognostic value of albumin to fibrinogen ratio for mortality in patients with hypertrophic cardiomyopathy

Prognostic value of albumin to fibrinogen ratio for mortality in patients with hypertrophic cardiomyopathy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prognostic value of albumin to fibrinogen ratio for mortality in patients with hypertrophic cardiomyopathy Liying Li, Chao Ban, Haiyan Ruan, Muxin Zhang, Ziqiong Wang, Min Ma, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2547038/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 16 Nov, 2023 Read the published version in BMC Cardiovascular Disorders → Version 1 posted 13 You are reading this latest preprint version Abstract Background Albumin to fibrinogen ratio (AFR) has emerged as a useful indicator for adverse outcomes in several diseases. However, whether the AFR could be a new useful indicator to predict mortality in HCM patients remains to be evaluated. The study investigated the predictive value of the AFR for HCM-related death in adult HCM patients. Methods A total of 404 HCM patients were retrospectively enrolled. Patients were divided into two groups based on the median of baseline AFR. The association between AFR and HCM-related death was analyzed. Results During a median follow-up duration of 4.75 years, 45 patients (11.1%) occurred in HCM-related death. The incidence of HCM-related death was significantly higher in the low AFR group (Log-rank p < 0.001). With the high AFR group as reference, the fully adjusted hazard ratios (HRs) of HCM-related death were 3.15 for the low AFR group (95% confidence interval [CI]: 0.16–0.64, p = 0.001). No significant interactions between AFR and other variables were observed in subgroup analysis. Sensitivity analyses in patients with normal albumin and fibrinogen have showed similar results. Conclusion AFR is an independent prognostic factor for HCM-related death in adult HCM patients. albumin fibrinogen hypertrophic cardiomyopathy prognosis inflammation Figures Figure 1 Figure 2 Figure 3 Figure 4 1. Introduction Hypertrophic cardiomyopathy (HCM) is one of the inherited cardiovascular diseases, caused primarily by sarcomere protein mutations and characterized by left ventricular hypertrophy that is not solely explained by abnormal loading conditions[ 1 , 2 ]. Although overall prognosis for HCM patients have been improved greatly with the development of clinical science in recent years[ 3 ], the cumulative burden of HCM is still substantial[ 4 ]. Therefore, we need to explore more indicators to predict prognosis for HCM patients and to make better risk stratify for those patients who were at high risk of adverse outcomes. Accumulating evidence has suggested the existence of low-grade systemic and local inflammation in HCM[ 5 – 7 ]. The persistent activation of cardiac inflammatory pathways may lead to significant myocardial fibrosis, cardiac hypertrophy, diastolic dysfunction in HCM patients[ 8 ], which will lead to adverse outcomes. Recently, some researches have showed a new inflammatory marker, albumin to fibrinogen ratio (AFR), was associated with adverse outcomes in various diseases, including peritonitis-induced sepsis[ 9 ], myocardial infarction[ 10 ], ischemic stroke[ 11 ], gastric cancer[ 12 ], bladder Cancer[ 13 ] and knee synovitis[ 14 ]. However, whether this indicator could be a useful prognostic factor for HCM patients remains unclear. The purpose of the study was to investigate the prognostic value of AFR for mortality in Chinese adult HCM patients. 2. Methods 2.1 Study patients This retrospective single-center cohort study was performed at West China Hospital of Sichuan University, a tertiary center hospital located in Chengdu, China. We included the hospitalized patients with a discharge diagnosis of HCM (n = 546) between December 2008 to November 2018. According to the guideline, the diagnosis of HCM was based on the presence of increased left ventricular wall thickness (≥ 15 mm)-as measured by any imaging technique-that was not solely explained by abnormal loading conditions[ 15 ]. The left ventricular outflow tract obstruction (LVOTO) was defined as a gradient ≥ 30 mmHg at rest. The twice-entry method was used for data entry. After rechecking by experienced cardiologist according to the criteria of the European Society of Cardiology (ESC)[ 16 ], 9 patients were excluded: cardiac amyloidosis (n = 5), restrictive cardiomyopathy (n = 2), dilated cardiomyopathy (n = 1) and myocarditis (n = 1). Among the remaining 537 patients, based on the inclusion and exclusion criteria, a total of 404 adult patients were enrolled for the present analysis (Fig. 1 ). The study was conducted according to the principles of the Declaration of Helsinki, and was approved by the Biomedical Research Ethics Committee, West China Hospital of Sichuan University (approval number: 2019 − 1147). It has been registered on the website of Chinese Clinical Trial Registry ( https://www.chictr.org.cn/enIndex.aspx ; registration number: ChiCTR2000029352). Informed consent was waived due to the retrospective nature of the study. Other detailed information has been reported in the recently published studies[ 17 , 18 ]. 2.2 Clinical evaluation The data were collected from medical records of the enrolled patients, baseline characteristics including medical histories, therapies, 12-lead ECG, peripheral blood parameters and Doppler echocardiography were collected by experienced physicians at the time of hospital admission for each patient. Serum albumin and fibrinogen were collected at the time of hospital admission. Normal ranges of serum albumin and fibrinogen in our clinical medical laboratory center, which is accredited by the American CAP Medical Laboratory, are 35–55 g/L and 2.0–4.0 g/L, respectively. The AFR was calculated using the following formula: AFR = serum albumin (g/L) / fibrinogen (g/L). 2.3 Study outcomes and Follow-up The endpoint was HCM-related death, including heart failure (HF)-related death, stroke-related death, sudden cardiac death (SCD), and perioperative death due to ventricular septal myectomy. Follow-up was carried out via medical records or telephone contact with the patients themselves and/or referring relatives. All patients were followed from the first evaluation up to the endpoint or the most recent evaluation. 2.4 Statistical analysis Patients were divided into two groups according to the median of AFR: low AFR group (AFR < 15.94) and high AFR group (AFR ≥ 15.94). For each group, continuous variables were presented as mean ± standard deviation (SD) and median with interquartile range (IQR) where appropriate, and categorical variables as number with percentages. Kruskal–Wallis test, Shapiro–Wilk test, Chi-square test or Fisher exact test were used for data analysis appropriately. Survival curves were constructed using Kaplan-Meier estimates, and HCM-related death rates were compared using the log-rank test. For prognostic analysis, Cox proportional hazard regression model was applied. Two multivariate models were constructed and variables for inclusion were carefully chosen to ensure parsimony of multivariate models. Model 1, the basic model, adjusted for demographic data, including age and gender. For model 2 were sought using a backward stepwise modeling approach including variables that showed a significant relationship with HCM-related death in univariate analysis (p < 0.05) and some clinically relevant variables. Additionally, stratified analysis was performed to assess whether the association between AFR and HCM-related death was consistent in various subgroups. Furthermore, sensitivity analysis was also conducted in patients with normal albumin and fibrinogen to assess the relationship between AFR and HCM-related death in case some other unknown reasons, which could affect the components of AFR, had not been ruled out. All analyses were performed with R version 4.1.0 (R Project for Statistical Computing) including the “compareGroups”, “rms”, “survminer”, “tidyverse”, “survival”, “timeROC”, “survivalROC”, “forestplot” and “stats” packages. A two-sided P value < 0.05 was considered statistically significant. 3. Results 3.1 Baseline characteristics The present study comprised 404 patients (male: 54.64%) with a median age of 57.00 (IQR: 46.00-67.00) years. Baseline characteristics of the two groups are summarized in Table 1 with details. Patients in the low AFR group were older and the proportion of women is high. Patients with hypertension and New York Heart Association III/IV (NYHA III/IV) were more common in low AFR group. Compared with patients in the high AFR group, hemoglobin (Hgb), albumin and alanine aminotransferase (ALT) was lower in the low AFR group, while platelet count (PLT), white blood cell count (WBCC) and fibrinogen was higher in these patients. There was no significant difference in family history of HCM, family history of SCD, vascular diseases, medical history, therapy, intervention of obstruction, AST and creatinine between the two groups. 3.2 Study endpoints During a median follow-up of 4.75 years (IQR: 2.2–6.8 years), HCM-related death occurred in 45 (11.2%) patients, including 22 HF-related death, 8 stroke-related death, 13 SCDs and 2 HCM-related postoperative death. 3.3 Association between AFR and mortality. The incidence of HCM-related death rate was significantly higher in the low AFR group (Log-rank p < 0.001) (Figure 2), as well as in HF-related death (Log-rank p = 0.006) and SCD (Log-rank p = 0.036) (Figure 3). Univariate Cox regression analysis indicated that AFR and some other variables could predict HCM-related death (Table S1). With the high AFR group as reference, unadjusted HRs for HCM-related death were 2.97 (95% CI: 0.17–0.65, p = 0.001) in the low AFR group. After adjusting potential confounders, the risk of HCM-related death for patients in the low AFR group were significantly over three-times higher than that of patients in the high AFR group (fully adjusted HR: 3.15, 95% CI: 0.16–0.64, p = 0.001) (Table 2). The results of stratified analysis showed that the mortality rates were consistently higher in the low AFR group in all subgroups and no interaction effect was observed between AFR and other variables for mortality prediction (Table 3). 3.4 Sensitivity analysis Sensitivity analysis was performed in patients with normal albumin and fibrinogen (n = 251) and it revealed similar results with the main analyses. There were 16 (6.3%) patients occurred in HCM-related death. Kaplan–Meier analysis demonstrated the incidence of HCM-related death was higher in the low AFR group (Log-rank p = 0.008) (Figure 4). With the high AFR group as reference, unadjusted HRs for HCM-related death were 4.72 (95% CI: 0.06-0.74, p = 0.016) in the low AFR group. Fully adjusted HRs for HCM-related death were 9.21 (95% CI: 0.02–0.51, p = 0.005) when compared with high AFR group (Table S2). 3.5 Correlation AFR was negatively correlated with age (r = −0.189, p < 0.001) and white blood cell count (r = −0.102, p = 0.041), and positively correlated with Hgb (r = 0.140, p = 0.005), ALT (r = 0.254, p < 0.001), AST (r = 0.245, p < 0.001) and maximal left ventricular wall thickness (r = 0.121, p = 0.015). In addition, AFR was no correlation with PLT, lipid and LVEDD and left atrial diameter (LAD) (Table S3). 4. Discussion The present study showed that AFR was a significant predictor for HCM-related death in adult HCM patients. Stratified analysis in subgroups and sensitivity analysis in patients with normal albumin and fibrinogen demonstrated similar results. To our knowledge, the present study firstly illustrated the prognostic value of baseline AFR in patients with HCM. Hypertrophic cardiomyopathy is a common monogenic inherited cardiovascular diseases with marked clinical heterogeneity[ 1 ], ranging from a normal lifespan without symptoms to poor outcomes such as advanced heart failure, SCD or stroke[ 19 ]. Histological studies supported the association between inflammation and HCM[ 5 , 6 ]. Compared with healthy controls, several inflammatory markers in peripheral blood were increased in HCM patients, such as high-sensitivity C-reactive protein[ 7 ], interleukin(IL)-6[ 20 ] and tumour necrosis factor(TNF)-α[ 21 ]. The persistent activation of cardiac inflammatory pathways is associated with myocardial fibrosis and remodeling, septal wall thickness and left ventricle diastolic dysfunction[ 5 , 6 ]. Myocardial fibrosis will result in electromechanical disturbances and reduce the nutrient supply toward the myocardium, perpetuating a vicious cycle of inflammation, fibrosis and myocyte death [ 6 , 22 ]. Meanwhile, myocardial fibrosis is a major determinant of heart failure, left ventricular dysfunction, ventricular tachyarrhythmia and SCD[ 23 – 25 ]. Thus, markers of inflammation serve as biomarkers for the disease severity and adverse outcomes of HCM patients. Albumin is a hepatic protein and usually acts as a negative acute-phase protein. Its plasma concentration is mainly influenced by several factors, including the rate of albumin synthesis, catabolism, and loss by renal. Histological studies supported low serum albumin level are linked to adverse outcomes of cardiovascular disease, including heart failure, atrial fibrillation, ischemic heart disease, myocardial infarction, stroke and venous thromboembolism[ 26 – 28 ]. In our cohort study, the level of AST and creatinine between the two groups was not significantly difference, which indicated there were no significant difference about the liver function and renal function between the two groups patients. Therefore, the main factors affecting serum albumin are inflammation and malnutrition in these patients. In addition, some studies have showed that malnutrition and inflammation played a major role in occurrence of low serum albumin levels [ 27 , 29 ] and the influence of inflammation on serum albumin levels seems to be stronger[ 30 , 31 ]. Fibrinogen, a positive acute-phase protein, produced in the liver upon stimulation of interleukin (IL)-6 and IL-1β, and its level increases in response to wound healing, infection, and inflammation[ 32 , 33 ]. Several studies have confirmed that plasma fibrinogen is a predictor of cardiovascular disease[ 34 , 35 ]. AFR, a novel inflammatory biomarker, has been widely proposed as a prognostic marker in various diseases[ 9 – 13 ]. AFR takes serum albumin (a negative acute-phase protein) and fibrinogen (a positive acute-phase protein) into account, it could better reflect the status of inflammation than alone. Gabay et al[ 36 ] found anemia and hypoalbuminemia due to inflammation are common among hospitalized patients. In our study, patients with lower AFR value had lower levels of Hgb and albumin, which demonstrating the presence of inflammation in these patients indirectly. Despite the lack of diagnostic specificity, AFR is still a useful indicator as its changes reflect the presence of inflammatory process of patients. Modulating inflammatory reactions in HCM patients may be a useful therapeutic approach for managing myocardial fibrosis and adverse outcome. The study has several limitations. Firstly, this was a single center, retrospective study, and those patients were from China, lack of region diversification and race comparison. Secondly, the most widely used inflammatory indicators including the plasma C-reactive protein concentration, erythrocyte sedimentation rate, or IL-6 were not determined, thus the correlations between AFR and well-established inflammation indicators are missing. Thirdly, we did not collect some known markers, such as non-sustained ventricular tachycardia, for HCM-related adverse outcomes, and this might partly result in the biases of the results. Finally, AFR was evaluated only initial evaluation, whether the dynamic changes of AFR could still predict HCM-related death is unclear. However, AFR is a simple and inexpensive routine laboratory test, which provides relevant prognostic information in patients with HCM. It could help with the risk stratification, follow-up facilitation and more aggressive treatment. Therefore, AFR should serve as a potential screening tool to identify individuals at higher risk for adverse outcomes. 5. Conclusion The present study indicated that AFR is an independent prognostic factor for HCM-related death, a lower AFR is associated with increased risk of HCM-related death in adult HCM patients. It is unknown whether prevention and correction of low AFR could improve outcome of patients with HCM, further prospective studies are needed to assess the relationship between AFR and the prognosis of HCM. Abbreviations HCM hypertrophic cardiomyopathy AFR albumin to fibrinogen ratio SCD sudden cardiac death TE thrombo-embolic event LVEDD left ventricular end-diastolic dimension LAD left atrial diameter MWT maximal left ventricular wall thickness LVEF left ventricular ejection fraction LVOTG left ventricular outflow tract gradient Hgb hemoglobin PLT Platelet count WBCC white blood cell count HDL-C high density lipoprotein cholesterin LDL-C low density lipoprotein cholesterin Declarations Acknowledgment We thank all staff members for data collection, data entry and monitoring as part of this study and all funding sources. Authors’ contributions SH conceived and supervised the study and performed statistical analysis of the data. LY was involved in the procedure and wrote the main body of the manuscript. CB participated in the discussion on the interpretation of the research content and took part in the procedure. YZ revised this paper. HY, MX, ZQ and MM participated in data collection. All authors critically revised and approved the final version of the manuscript. All authors read and approved the final manuscript. Funding The study was supported by Sichuan Science and Technology Program, China (Grant No. 2022YFS0186), and the National Natural Science Foundation of China (Grant No. 81600299). Availability of data and materials The datasets used during the current study are available from the corresponding author on reasonable request. Ethics approval and consent to participate Informed consent was waived due to the retrospective nature of the study. It was approved by the Biomedical Research Ethics Committee, West China Hospital of Sichuan University (approval number: 2019-1147). Consent for publication Not applicable Competing interests The authors declare that they have no competing interests References Ommen SR, et al. 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: Executive Summary. Circulation. 2020, 142(25): e533-57. Esposito A, et al. Prevalence and clinical implications of hyperhomocysteinaemia in patients with hypertrophic cardiomyopathy and MTHFR C6777T polymorphism. Eur J Prev Cardiol. 2020, 27(17):1906-8. Maron BJ, Maron MS, Rowin EJ. Perspectives on the Overall Risks of Living With Hypertrophic Cardiomyopathy. Circulation. 2017, 135(24):2317-9. Ho CY, et al. Genotype and Lifetime Burden of Disease in Hypertrophic Cardiomyopathy. Circulation. 2018, 138(14):1387-98. Becker RC, Owens AP, Sadayappan S. Tissue-level inflammation and ventricular remodeling in hypertrophic cardiomyopathy. J Thromb Thrombolysis. 2020, 49(2):177-83. Monda E, et al. Molecular Basis of Inflammation in the Pathogenesis of Cardiomyopathies. Int J Mol Sci. 2020, 21(18):6462. Zhu L, et al. Prognostic Significance of Plasma High-Sensitivity C-Reactive Protein in Patients With Hypertrophic Cardiomyopathy. J Am Heart Assoc. 2017, 6(2):e004529. Fang L, et al. Systemic inflammation is associated with myocardial fibrosis, diastolic dysfunction, and cardiac hypertrophy in patients with hypertrophic cardiomyopathy. Am J Transl Res. 2017, 9(11):5063-73. Tai H, et al. Albumin-to-Fibrinogen Ratio Independently Predicts 28-Day Mortality in Patients with Peritonitis-Induced Sepsis. Mediators Inflamm. 2020, 2020:7280708. Xiao L, et al. The impact of preoperative fibrinogen-albumin ratio on mortality in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Clin Chim Acta. 2019, 493:8-13. Ruan Y, et al. High fibrinogen-to-albumin ratio is associated with hemorrhagic transformation in acute ischemic stroke patients. Brain Behav. 2021, 11(1):e01855. You X, et al. Preoperative albumin-to-fibrinogen ratio predicts severe postoperative complications in elderly gastric cancer subjects after radical laparoscopic gastrectomy. BMC Cancer. 2019, 19(1):931. Li S, et al. Prognostic Value of Preoperative Albumin-to-Fibrinogen Ratio in Patients with Bladder Cancer. J Cancer. 2021, 12(19):5864-73. Gao K, et al. Novel inflammatory markers in the blood of patients with knee synovitis. J Int Med Res. 2021, 49(7): 3000605211029557. Lang RM, et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogra. 2015, 28(1):1-39.e14. Elliott PM, et al. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy The Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J. 2014, 35(39):2733-79. Wang Z, Zhao L, He S. Prognostic nutritional index and the risk of mortality in patients with hypertrophic cardiomyopathy. Int J Cardiol. 2021, 331:152-7. Liao H, et al. Myocardial contraction fraction predicts mortality for patients with hypertrophic cardiomyopathy. Sci Rep. 2020,10(1):17026. Maron BJ, Maron MS. Hypertrophic cardiomyopathy. Lancet. 2013, 381(9862):242-55. Hogye M, et al. Comparison of circulating levels of interleukin-6 and tumor necrosis factor-alpha in hypertrophic cardiomyopathy and in idiopathic dilated cardiomyopathy. Am J Cardiol. 2004, 94(2):249-51. Zen K, et al. Analysis of circulating apoptosis mediators and proinflammatory cytokines in patients with idiopathic hypertrophic cardiomyopathy - Comparison between nonobstructive and dilated-phase hypertrophic cardiomyopathy. Int Heart J. 2005, 46(2):231-44. Piek A, de Boer RA, Sillje HHW. The fibrosis-cell death axis in heart failure. Heart Fail Rev. 2016,21(2):199-211. Ho CY, et al. Myocardial Fibrosis as an Early Manifestation of Hypertrophic Cardiomyopathy. N Engl J Med. 2010, 363(6):552-63. Varnava AM, et al. Hypertrophic cardiomyopathy: the interrelation of disarray, fibrosis, and small vessel disease. Heart. 2000, 84(5):476-82. Adabag AS, et al. Occurrence and frequency of arrhythmias in hypertrophic cardiomyopathy on relation to delayed enhancement on cardiovascular magnetic resonance. J Am Coll Cardiol. 2008, 51(14):1369-74. Arques S. Human serum albumin in cardiovascular diseases. Eur J Intern Med. 2018, 52:8-12. Arques S, Ambrosi P. Human Serum Albumin in the Clinical Syndrome of Heart Failure. J Card Fail. 2011, 17(6):451-8. Djousse L, et al. Serum albumin and risk of myocardial infarction and all-cause mortality in the Framingham Offspring Study. Circulation. 2002, 106(23):2919-24. Wada H, et al. Impact of serum albumin levels on long-term outcomes in patients undergoing percutaneous coronary intervention. Heart Vessels. 2017, 32(9):1085-92. Eckart A, et al. Relationship of Nutritional Status, Inflammation, and Serum Albumin Levels During Acute Illness: A Prospective Study. Am J Med. 2020, 133(6):713-22. Kaysen GA, et al. Inflammation and reduced albumin synthesis associated with stable decline in serum albumin in hemodialysis patients. Kidney Int. 2004, 65(4):1408-15. Tennent GA, et al. Human plasma fibrinogen is synthesized in the liver. Blood. 2007, 109(5):1971-4. Yamaguchi T, et al. Involvement of interleukin-6 in the elevation of plasma fibrinogen levels in lung cancer patients. Japan J Clin Oncol. 1998, 28(12):740-4. Deveci B, Gazi E. Relation Between Globulin, Fibrinogen, and Albumin With the Presence and Severity of Coronary Artery Disease. Angiology. 2021, 72(2):174-80. Kannel WB, et al. Fibrinogen and risk of cardiovascular disease. The Framingham Study. JAMA. 1987, 258(9):1183-6. Gabay C, Kushner I. Mechanisms of disease: Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999, 340(6):448-54. Tables Table 1. Baseline characteristics. Variable All (n=404) Low AFR (n=202) High AFR (n=202) p value Age (years) 57.00 (46.00, 67.00) 60.00 (49.00, 68.75) 53.00 (42.25, 65.00) <0.001 Gender, male 220 (54.46%) 95 (47.03%) 125 (61.88%) 0.004 Family history of HCM 36 (8.91%) 19 (9.41%) 17 (8.42%) 0.861 Family history of SCD 14 (3.47%) 6 (2.97%) 8 (3.96%) 0.786 NYHA III-IV 143 (35.40%) 84 (41.58%) 59 (29.21%) 0.013 SBP (mmHg) 120.00 (110.00, 136.00) 120.00 (108.00, 140.00) 120.00 (110.00, 132.00) 0.468 DBP (mmHg) 71.00 (65.00, 80.00) 70.00 (64.00, 80.00) 74.00 (65.25, 80.00) 0.305 Smoke 137 (33.91%) 67 (33.17%) 70 (34.65%) 0.834 Symptom Dyspnea 237 (58.66%) 123 (60.89%) 114 (56.44%) 0.419 Chest pain 233 (57.67%) 113 (55.94%) 120 (59.41%) 0.546 Syncope/pre-syncope 136 (33.66%) 65 (32.18%) 71 (35.15%) 0.599 Palpitation 159 (39.36%) 79 (39.11%) 80 (39.60%) 1.000 Medical history Prior TE 20 (4.95%) 11 (5.45%) 9 (4.46%) 0.819 Vascular diseases 34 (8.42%) 18 (8.91%) 16 (7.92%) 0.858 Hypertension 130 (32.18%) 75 (37.13%) 55 (27.23%) 0.043 Diabetes 29 (7.18%) 17 (8.42%) 12 (5.94%) 0.441 Atrial fibrillation 77 (19.06%) 35 (17.33%) 42 (20.79%) 0.447 Therapy Aspirin 77 (19.06%) 39 (19.31%) 38 (18.81%) 1.000 Clopidogrel 26 (6.44%) 13 (6.44%) 13 (6.44%) 1.000 Warfarin 41 (10.15%) 20 (9.90%) 21 (10.40%) 1.000 Beta blockers 305 (75.50%) 147 (72.77%) 158 (78.22%) 0.247 ACEI or ARB 86 (21.29%) 48 (23.76%) 38 (18.81%) 0.274 Intervention of obstruction 0.134 None 356 (88.12%) 184 (91.09%) 172 (85.15%) Alcohol septal ablation 42 (10.40%) 15 (7.43%) 27 (13.37%) Septal myectomy 6 (1.49%) 3 (1.49%) 3 (1.49%) Device 0.650 None 354 (87.62%) 179 (88.61%) 175 (86.63%) Pacemaker 17 (4.21%) 9 (4.46%) 8 (3.96%) ICD 33 (8.17%) 14 (6.93%) 19 (9.41%) Echocardiographic LVEDD (mm) 43.00 (40.00, 47.00) 43.00 (39.00, 47.00) 43.00 (40.00, 47.00) 0.729 LAD (mm) 40.00 (36.00, 45.00) 40.00 (36.00, 45.00) 41.00 (36.00, 45.75) 0.220 MWT (mm) 19.00 (17.00, 22.00) 19.00 (16.00, 21.00) 20.00 (17.00, 23.00) 0.003 LVEF (%) 68.00 (63.00, 72.00) 68.00 (63.00, 72.00) 69.00 (64.00, 72.75) 0.389 Resting LVOTG ≥ 30 mm Hg 0.43 (0.50) 0.43 (0.50) 0.43 (0.50) 1.000 Laboratory tests Hgb (g/L) 138.50 (126.75, 151.00) 135.00 (123.00, 146.00) 143.00 (131.00, 154.00) <0.001 PLT (10 9 /L) 146.00 (110.00, 186.00) 153.00 (113.00, 198.50) 141.00 (108.25, 173.75) 0.024 WBCC (10 9 /L) 6.31 (5.20, 7.71） 6.46 (5.34, 8.31) 6.12 (5.10, 7.27) 0.017 Albumin (g/L) 42.40 (39.88, 45.02) 41.25 (38.45, 43.40) 43.65 (41.70, 46.30) <0.001 ALT (IU/L) 23.00 (16.00, 34.00) 21.00 (15.00, 33.00) 24.00 (18.00, 34.75) 0.020 AST (IU/L) 26.00 (21.00, 32.00) 26.00 (20.00, 33.00) 26.00 (21.00, 32.00) 0.814 Glucose (mmol/L) 5.44 (4.88, 6.43) 5.42 (4.88, 6.53) 5.46 (4.89, 6.33) 0.723 Creatinine (μmol/L) 80.60 (67.22, 94.03) 81.00 (66.03, 96.00) 80.25 (68.40, 92.40) 0.837 TG (mmol/L) 1.26 (0.96, 1.87) 1.25 (0.93, 1.70) 1.28 (0.97, 1.98) 0.187 TC (mmol/L) 4.28 (3.56, 4.82) 4.28 (3.64, 4.82) 4.26 (3.50, 4.82) 0.652 HDL-C (mmol/L) 1.27 (1.03, 1.54) 1.29 (1.02, 1.56) 1.26 (1.03, 1.51) 0.668 LDL-C (mmol/L) 2.43 ± 0.76 2.42 ± 0.76 2.44 ± 0.76 0.841 Fibrinogen (g/L) 2.65 (2.26, 3.28) 3.28 (2.87, 3.70) 2.26 (2.02, 2.47) <0.001 Values are mean ± SD or median (IQR) or n (%). HCM = hypertrophic cardiomyopathy, AFR = albumin to fibrinogen ratio, SCD = sudden cardiac death, NYHA = New York Heart Association, SBP = systolic blood pressure, DBP = diastolic blood pressure, TE = thrombo-embolic event, ACEI = angiotensin-converting enzyme inhibitor , ARB = angiotensin receptor blocker, ICD = implantable cardioverter defibrillator, LVEDD = left ventricular end-diastolic dimension, LAD = left atrial diameter, MWT = maximal left ventricular wall thickness, LVEF = left ventricular ejection fraction, LVOTG = left ventricular outflow tract gradient, Hgb = hemoglobin, PLT = Platelet count, WBCC = white blood cell count, ALT = alanine aminotransferase, AST = aspartate aminotransferase, TG = triglyceride, TC = Cholesterol, HDL-C = high density lipoprotein cholesterin, LDL-C = low density lipoprotein cholesterin. Table 2. Associations of AFR with HCM-related death. High AFR Low AFR No. of patients (n) 202 202 Endpoints (n) 12 33 Follow-up (PYs) 995.4 904.51 Mortality rates ⁎ (95% CI) 1.2 (0.5-1.9) 3.6 (2.4-4.9) Unadjusted HRs (95% CI), p 1 2.97 (0.17-0.65), 0.001 Adjusted HRs (95% CI), p model 1 1 2.80 (0.18-0.70), 0.003 model 2 1 3.15 (0.16-0.64), 0.001 ⁎ Per 100 PYs, PYs = person-years, CI = confidence interval, HRs = hazard ratios. Model 1 with adjustment for age and gender. Model 2 with adjustment for age, gender, dyspnea, NYHA III-IV, family history of SCD, AF, AST, TG, MWT, and resting LVOTO. Abbreviations as in table 1. Table 3. Stratified analyses of HCM-related death. Subgroups Low AFR High AFR Adjusted HRs (95% CI), p p for interaction HCM-related death / Total patients. Gender Male 16/95 (16.8%) 5/125 (4.00%) 4.96 (0.07-0.62), 0.005 0.678 Female 17 /107 (15.9%) 7/77 (9.09%) 3.70 (0.10-0.73), 0.010 Age (years) <57 11/77 (14.3%) 7/116 (6.03%) 3.07 (0.12-0.90), 0.030 0.615 ≥57 22/125 (17.6%) 5/86 (5.81%) 4.13 (0.08-0.72), 0.011 NYHA III-IV No 15/118 (12.7%) 7/143 (4.90%) 3.96 (0.09-0.70), 0.008 0.881 Yes 18/84 (21.4%) 5/59 (8.47%) 3.14 (0.11-0.93), 0.037 Hypertension No 23/127 (18.1%) 10/147 (6.80%) 3.19 (0.14-0.70), 0.005 0.676 Yes 10/75 (13.3%) 2/55 (3.64%) 4.54 (0.04-1.24), 0.086 AF No 21/167 (12.6%) 3/160 (1.88%) 6.51 (0.04-0.53), 0.003 0.144 Yes 12/35 (34.3%) 9/42 (21.4%) 2.72 (0.13-1.06), 0.065 Warfarin No 26/182 (14.3%) 7/181 (3.87%) 3.76 (0.11-0.64), 0.003 0.62 Yes 7/20 (35.0%) 5/21 (23.8%) 2.96 (0.02-4.89), 0.426 Beta blockers No 9/55 (16.4%) 4/44 (9.09%) 2.10 (0.12-1.87), 0.288 0.484 Yes 24/147 (16.3%) 8/158 (5.06%) 4.99 (0.08-0.51), <0.001 Hgb (g/L) <138 23/114 (20.2%) 6/74 (8.11%) 4.12 (0.09-0.68), 0.007 0.523 ≥138 10/88 (11.4%) 6/128 (4.69%) 2.72 (0.12-1.13), 0.081 AST (IU/L) <26 9/100 (9.00%) 3/96 (3.12%) 3.24 (0.07-1.42), 0.131 0.237 ≥26 24/102 (23.5%) 9/106 (8.49%) 3.26 (0.14-0.69), 0.004 TG (mmol/L) <1.26 20/104 (19.2%) 8/96 (8.33%) 3.01 (0.13-0.85), 0.021 0.148 ≥1.26 13/98 (13.3%) 4/106 (3.77%) 7.17 (0.03-0.59), 0.007 LVEDD (mm) <43 20/97 (20.6%) 9/96 (9.38%) 2.51 (0.17-0.92), 0.031 0.181 ≥43 13/105 (12.4%) 3/106 (2.83%) 4.81 (0.05-0.90), 0.036 LVEF (%) <68 15/93 (16.1%) 9/90 (10.0%) 2.02 (0.19-1.26), 0.141 0.467 ≥68 18/109 (16.5%) 3/112 (2.68%) 5.56 (0.05-0.66), 0.010 Note: Each stratification adjusted for age, gender, dyspnea, NYHA class, AF, AST, TG, LVEDD, LVEF, Resting LVOTG ≥ 30 mm Hg, except the stratification factor itself. Abbreviations as in tables 1 and 2. Additional Declarations No competing interests reported. Supplementary Files FigureS1.tiff FigureS2.tiff TableS1.docx TableS2.docx TableS3.docx Cite Share Download PDF Status: Published Journal Publication published 16 Nov, 2023 Read the published version in BMC Cardiovascular Disorders → Version 1 posted Editorial decision: Major revision 09 Jun, 2023 Reviewers agreed at journal 01 Jun, 2023 Reviews received at journal 31 May, 2023 Reviewers agreed at journal 12 May, 2023 Reviewers agreed at journal 11 May, 2023 Reviewers agreed at journal 26 Mar, 2023 Reviews received at journal 23 Mar, 2023 Reviewers agreed at journal 23 Mar, 2023 Reviewers invited by journal 16 Mar, 2023 Editor assigned by journal 27 Feb, 2023 Editor invited by journal 15 Feb, 2023 Submission checks completed at journal 15 Feb, 2023 First submitted to journal 03 Feb, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2547038","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":176289398,"identity":"935c3d26-3d71-4c4f-9a9c-19a6dc54693e","order_by":0,"name":"Liying Li","email":"","orcid":"","institution":"West China Hospital of Sichuan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Liying","middleName":"","lastName":"Li","suffix":""},{"id":176289399,"identity":"20a89b6f-1f50-4a02-b4aa-f32f606819c3","order_by":1,"name":"Chao Ban","email":"","orcid":"","institution":"West China Hospital of Sichuan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chao","middleName":"","lastName":"Ban","suffix":""},{"id":176289400,"identity":"67dd3c0e-a837-48e5-958b-1ba50761bc1d","order_by":2,"name":"Haiyan Ruan","email":"","orcid":"","institution":"West China Hospital of Sichuan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Haiyan","middleName":"","lastName":"Ruan","suffix":""},{"id":176289401,"identity":"034cc3dd-978a-4166-9261-fe3782824b96","order_by":3,"name":"Muxin Zhang","email":"","orcid":"","institution":"West China Hospital of Sichuan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Muxin","middleName":"","lastName":"Zhang","suffix":""},{"id":176289402,"identity":"da6aa544-c7df-47f8-a291-c13a0004e6f0","order_by":4,"name":"Ziqiong Wang","email":"","orcid":"","institution":"West China Hospital of Sichuan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ziqiong","middleName":"","lastName":"Wang","suffix":""},{"id":176289403,"identity":"75b8f2e8-38d4-4247-b48d-633b9166e9a9","order_by":5,"name":"Min Ma","email":"","orcid":"","institution":"West China Hospital of Sichuan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Min","middleName":"","lastName":"Ma","suffix":""},{"id":176289404,"identity":"f14d0663-6606-468c-bbe2-e85a1c6f6c9a","order_by":6,"name":"Yi Zheng","email":"","orcid":"","institution":"West China Hospital of Sichuan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yi","middleName":"","lastName":"Zheng","suffix":""},{"id":176289405,"identity":"6e11896d-1909-49c5-8ebb-3b6a948443ac","order_by":7,"name":"Sen He","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyUlEQVRIiWNgGAWjYBACAyidwMDMwPggoaKGJC3MzAYPzhwjRQsDM5vkwxZmwlrM2dsfPi74czhPt53/WEViAxsDf3t3Al4tlj1njI1nth0uNjvMzHYjcYcMg8SZsxvwO+xGDps0b8PhxG1gLWfYGAwkcglouf/8+W+ePxAtBYltzERoucFgxszDBtHCQJyWMznG0rxt6SC/GEsknDnGQ9gvx48//MzzxzrP7PzBhx9/VNTI8bf34teCAXhIUz4KRsEoGAWjACsAAPQuSbuZH/w0AAAAAElFTkSuQmCC","orcid":"","institution":"West China Hospital of Sichuan University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Sen","middleName":"","lastName":"He","suffix":""}],"badges":[],"createdAt":"2023-02-03 13:44:32","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2547038/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2547038/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12872-023-03562-8","type":"published","date":"2023-11-16T15:01:08+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":33040273,"identity":"581a62b3-66e5-4477-93d0-014731ca417c","added_by":"auto","created_at":"2023-02-16 15:31:39","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":585403,"visible":true,"origin":"","legend":"\u003cp\u003eStudy flow diagram.\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-2547038/v1/93f1c54ff06d8ef0fa418652.png"},{"id":33039718,"identity":"5624624a-b532-4ec4-9b8b-211571ec485c","added_by":"auto","created_at":"2023-02-16 15:23:39","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":26285,"visible":true,"origin":"","legend":"\u003cp\u003eBaseline AFR and HCM-related death by Kaplan-Meier curve analysis. Patients in the low AFR group (AFR\u0026lt;15.94) had higher incidence of HCM-related death than in the high AFR group (AFR≥15.94) (Log-rank p \u0026lt; 0.001). AFR: albumin to fibrinogen ratio.\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-2547038/v1/fc95506a5f6150f4ec9c117b.png"},{"id":33039719,"identity":"c847ed95-9dcc-4b9a-9ea5-578e2638a390","added_by":"auto","created_at":"2023-02-16 15:23:39","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":49051,"visible":true,"origin":"","legend":"\u003cp\u003eKaplan–Meier survival curve analysis for HF-related death (A) and SCD (B) by baseline AFR.\u003c/p\u003e","description":"","filename":"Figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-2547038/v1/f04cbde1bdd372b6672c2412.png"},{"id":33040274,"identity":"c234887c-ca98-4ef8-8a30-dabeb831ec52","added_by":"auto","created_at":"2023-02-16 15:31:39","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":25964,"visible":true,"origin":"","legend":"\u003cp\u003eKaplan–Meier survival curve analysis in HCM patients with normal albumin and fibrinogen. Patients in the low AFR group had higher incidence of HCM-related death than those in the high AFR group (Log-rank p = 0.008).\u003c/p\u003e","description":"","filename":"Figure4.png","url":"https://assets-eu.researchsquare.com/files/rs-2547038/v1/f79722b2dc12436b271b803f.png"},{"id":46779972,"identity":"f017bed7-40ec-44d4-84c0-9ba010cadf21","added_by":"auto","created_at":"2023-11-20 15:08:38","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":695368,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2547038/v1/c95454b5-8f90-488a-97b8-5471bb3f21c7.pdf"},{"id":33039722,"identity":"191ac263-e8d2-4134-8478-a7614ae4bf3b","added_by":"auto","created_at":"2023-02-16 15:23:39","extension":"tiff","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":4674268,"visible":true,"origin":"","legend":"","description":"","filename":"FigureS1.tiff","url":"https://assets-eu.researchsquare.com/files/rs-2547038/v1/5906b64e2f591f4ee199086a.tiff"},{"id":33039726,"identity":"794c97bd-d4b0-4c7c-932c-cd7af9b14ff2","added_by":"auto","created_at":"2023-02-16 15:23:39","extension":"tiff","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":2445328,"visible":true,"origin":"","legend":"","description":"","filename":"FigureS2.tiff","url":"https://assets-eu.researchsquare.com/files/rs-2547038/v1/d4f134e4521e3447da8bcebe.tiff"},{"id":33039725,"identity":"b0e5ec7d-02c9-42a9-a081-effb1bae303c","added_by":"auto","created_at":"2023-02-16 15:23:39","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":48701,"visible":true,"origin":"","legend":"","description":"","filename":"TableS1.docx","url":"https://assets-eu.researchsquare.com/files/rs-2547038/v1/93e881c3c939f9fe6ca1b326.docx"},{"id":33039720,"identity":"66d4cf51-beda-4610-89a0-a84962a478a4","added_by":"auto","created_at":"2023-02-16 15:23:39","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":29272,"visible":true,"origin":"","legend":"","description":"","filename":"TableS2.docx","url":"https://assets-eu.researchsquare.com/files/rs-2547038/v1/62cae78f5a8a31afadfd9219.docx"},{"id":33039724,"identity":"a6a4c354-906b-40d4-8777-5d93e958151e","added_by":"auto","created_at":"2023-02-16 15:23:39","extension":"docx","order_by":5,"title":"","display":"","copyAsset":false,"role":"supplement","size":31173,"visible":true,"origin":"","legend":"","description":"","filename":"TableS3.docx","url":"https://assets-eu.researchsquare.com/files/rs-2547038/v1/5780698d7c1e729d9b93a74c.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prognostic value of albumin to fibrinogen ratio for mortality in patients with hypertrophic cardiomyopathy","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eHypertrophic cardiomyopathy (HCM) is one of the inherited cardiovascular diseases, caused primarily by sarcomere protein mutations and characterized by left ventricular hypertrophy that is not solely explained by abnormal loading conditions[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Although overall prognosis for HCM patients have been improved greatly with the development of clinical science in recent years[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e], the cumulative burden of HCM is still substantial[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Therefore, we need to explore more indicators to predict prognosis for HCM patients and to make better risk stratify for those patients who were at high risk of adverse outcomes.\u003c/p\u003e \u003cp\u003eAccumulating evidence has suggested the existence of low-grade systemic and local inflammation in HCM[\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The persistent activation of cardiac inflammatory pathways may lead to significant myocardial fibrosis, cardiac hypertrophy, diastolic dysfunction in HCM patients[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], which will lead to adverse outcomes. Recently, some researches have showed a new inflammatory marker, albumin to fibrinogen ratio (AFR), was associated with adverse outcomes in various diseases, including peritonitis-induced sepsis[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e], myocardial infarction[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], ischemic stroke[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], gastric cancer[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], bladder Cancer[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] and knee synovitis[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. However, whether this indicator could be a useful prognostic factor for HCM patients remains unclear. The purpose of the study was to investigate the prognostic value of AFR for mortality in Chinese adult HCM patients.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study patients\u003c/h2\u003e \u003cp\u003eThis retrospective single-center cohort study was performed at West China Hospital of Sichuan University, a tertiary center hospital located in Chengdu, China. We included the hospitalized patients with a discharge diagnosis of HCM (n\u0026thinsp;=\u0026thinsp;546) between December 2008 to November 2018. According to the guideline, the diagnosis of HCM was based on the presence of increased left ventricular wall thickness (\u0026ge;\u0026thinsp;15 mm)-as measured by any imaging technique-that was not solely explained by abnormal loading conditions[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The left ventricular outflow tract obstruction (LVOTO) was defined as a gradient\u0026thinsp;\u0026ge;\u0026thinsp;30 mmHg at rest. The twice-entry method was used for data entry. After rechecking by experienced cardiologist according to the criteria of the European Society of Cardiology (ESC)[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], 9 patients were excluded: cardiac amyloidosis (n\u0026thinsp;=\u0026thinsp;5), restrictive cardiomyopathy (n\u0026thinsp;=\u0026thinsp;2), dilated cardiomyopathy (n\u0026thinsp;=\u0026thinsp;1) and myocarditis (n\u0026thinsp;=\u0026thinsp;1). Among the remaining 537 patients, based on the inclusion and exclusion criteria, a total of 404 adult patients were enrolled for the present analysis (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e The study was conducted according to the principles of the Declaration of Helsinki, and was approved by the Biomedical Research Ethics Committee, West China Hospital of Sichuan University (approval number: 2019\u0026thinsp;\u0026minus;\u0026thinsp;1147). It has been registered on the website of Chinese Clinical Trial Registry (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.chictr.org.cn/enIndex.aspx\u003c/span\u003e\u003cspan address=\"https://www.chictr.org.cn/enIndex.aspx\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e; registration number: ChiCTR2000029352). Informed consent was waived due to the retrospective nature of the study. Other detailed information has been reported in the recently published studies[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Clinical evaluation\u003c/h2\u003e \u003cp\u003eThe data were collected from medical records of the enrolled patients, baseline characteristics including medical histories, therapies, 12-lead ECG, peripheral blood parameters and Doppler echocardiography were collected by experienced physicians at the time of hospital admission for each patient. Serum albumin and fibrinogen were collected at the time of hospital admission. Normal ranges of serum albumin and fibrinogen in our clinical medical laboratory center, which is accredited by the American CAP Medical Laboratory, are 35\u0026ndash;55 g/L and 2.0\u0026ndash;4.0 g/L, respectively. The AFR was calculated using the following formula: AFR\u0026thinsp;=\u0026thinsp;serum albumin (g/L) / fibrinogen (g/L).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Study outcomes and Follow-up\u003c/h2\u003e \u003cp\u003eThe endpoint was HCM-related death, including heart failure (HF)-related death, stroke-related death, sudden cardiac death (SCD), and perioperative death due to ventricular septal myectomy. Follow-up was carried out via medical records or telephone contact with the patients themselves and/or referring relatives. All patients were followed from the first evaluation up to the endpoint or the most recent evaluation.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Statistical analysis\u003c/h2\u003e \u003cp\u003ePatients were divided into two groups according to the median of AFR: low AFR group (AFR\u0026thinsp;\u0026lt;\u0026thinsp;15.94) and high AFR group (AFR\u0026thinsp;\u0026ge;\u0026thinsp;15.94). For each group, continuous variables were presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD) and median with interquartile range (IQR) where appropriate, and categorical variables as number with percentages. Kruskal\u0026ndash;Wallis test, Shapiro\u0026ndash;Wilk test, Chi-square test or Fisher exact test were used for data analysis appropriately. Survival curves were constructed using Kaplan-Meier estimates, and HCM-related death rates were compared using the log-rank test. For prognostic analysis, Cox proportional hazard regression model was applied. Two multivariate models were constructed and variables for inclusion were carefully chosen to ensure parsimony of multivariate models. Model 1, the basic model, adjusted for demographic data, including age and gender. For model 2 were sought using a backward stepwise modeling approach including variables that showed a significant relationship with HCM-related death in univariate analysis (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and some clinically relevant variables. Additionally, stratified analysis was performed to assess whether the association between AFR and HCM-related death was consistent in various subgroups. Furthermore, sensitivity analysis was also conducted in patients with normal albumin and fibrinogen to assess the relationship between AFR and HCM-related death in case some other unknown reasons, which could affect the components of AFR, had not been ruled out.\u003c/p\u003e \u003cp\u003eAll analyses were performed with R version 4.1.0 (R Project for Statistical Computing) including the \u0026ldquo;compareGroups\u0026rdquo;, \u0026ldquo;rms\u0026rdquo;, \u0026ldquo;survminer\u0026rdquo;, \u0026ldquo;tidyverse\u0026rdquo;, \u0026ldquo;survival\u0026rdquo;, \u0026ldquo;timeROC\u0026rdquo;, \u0026ldquo;survivalROC\u0026rdquo;, \u0026ldquo;forestplot\u0026rdquo; and \u0026ldquo;stats\u0026rdquo; packages. A two-sided P value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003e3.1 Baseline characteristics\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe present study comprised 404 patients (male: 54.64%) with a median age of 57.00 (IQR: 46.00-67.00) years. Baseline characteristics of the two groups are summarized in Table 1 with details. Patients in the low AFR group were older and the proportion of women is high. Patients with hypertension and New York Heart Association III/IV (NYHA III/IV) were more common in low AFR group. Compared with patients in the high AFR group, hemoglobin (Hgb), albumin and alanine aminotransferase (ALT) was lower in the low AFR group, while platelet count (PLT), white blood cell count (WBCC) and fibrinogen was higher in these patients. There was no significant difference in family history of HCM, family history of SCD, vascular diseases, medical history, therapy, intervention of obstruction, AST and creatinine between the two groups.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e3.2 \u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eStudy endpoints\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDuring a median follow-up of 4.75 years (IQR: 2.2\u0026ndash;6.8 years), HCM-related death occurred in 45 (11.2%) patients, including 22 HF-related death, 8 stroke-related death, 13 SCDs and 2 HCM-related postoperative death.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e3.3 Association between AFR and mortality.\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe incidence of HCM-related death rate was significantly higher in the low AFR group (Log-rank p \u0026lt; 0.001) (Figure 2), as well as in HF-related death (Log-rank p = 0.006) and SCD (Log-rank p = 0.036) (Figure 3). Univariate Cox regression analysis indicated that AFR and some other variables could predict HCM-related death (Table S1). With the high AFR group as reference, unadjusted HRs for HCM-related death were 2.97 (95% CI: 0.17\u0026ndash;0.65, p = 0.001) in the low AFR group. After adjusting potential confounders, the risk of HCM-related death for patients in the low AFR group were significantly over three-times higher than that of patients in the high AFR group (fully adjusted HR: 3.15, 95% CI: 0.16\u0026ndash;0.64, p = 0.001) (Table 2). The results of stratified analysis showed that the mortality rates were consistently higher in the low AFR group in all subgroups and no interaction effect was observed between AFR and other variables for mortality prediction (Table 3).\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e3.4 Sensitivity analysis\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSensitivity analysis was performed in patients with normal albumin and fibrinogen (n = 251) and it revealed similar results with the main analyses. There were 16 (6.3%) patients occurred in HCM-related death. Kaplan\u0026ndash;Meier analysis demonstrated the incidence of HCM-related death was higher in the low AFR group (Log-rank p = 0.008) (Figure 4). With the high AFR group as reference, unadjusted HRs for HCM-related death were 4.72 (95% CI: 0.06-0.74, p = 0.016) in the low AFR group. Fully adjusted HRs for HCM-related death were 9.21 (95% CI: 0.02\u0026ndash;0.51, p = 0.005) when compared with high AFR group (Table S2). \u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e3.5 Correlation\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAFR was negatively correlated with age (r = \u0026minus;0.189, p \u0026lt; 0.001) and white blood cell count (r = \u0026minus;0.102, p = 0.041), and positively correlated with Hgb (r = 0.140, p = 0.005), ALT (r = 0.254, p \u0026lt; 0.001), AST (r = 0.245, p \u0026lt; 0.001) and maximal left ventricular wall thickness (r = 0.121, p = 0.015). In addition, AFR was no correlation with PLT, lipid and LVEDD and left atrial diameter (LAD) (Table S3).\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThe present study showed that AFR was a significant predictor for HCM-related death in adult HCM patients. Stratified analysis in subgroups and sensitivity analysis in patients with normal albumin and fibrinogen demonstrated similar results. To our knowledge, the present study firstly illustrated the prognostic value of baseline AFR in patients with HCM.\u003c/p\u003e \u003cp\u003eHypertrophic cardiomyopathy is a common monogenic inherited cardiovascular diseases with marked clinical heterogeneity[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], ranging from a normal lifespan without symptoms to poor outcomes such as advanced heart failure, SCD or stroke[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Histological studies supported the association between inflammation and HCM[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Compared with healthy controls, several inflammatory markers in peripheral blood were increased in HCM patients, such as high-sensitivity C-reactive protein[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], interleukin(IL)-6[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] and tumour necrosis factor(TNF)-α[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. The persistent activation of cardiac inflammatory pathways is associated with myocardial fibrosis and remodeling, septal wall thickness and left ventricle diastolic dysfunction[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Myocardial fibrosis will result in electromechanical disturbances and reduce the nutrient supply toward the myocardium, perpetuating a vicious cycle of inflammation, fibrosis and myocyte death [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Meanwhile, myocardial fibrosis is a major determinant of heart failure, left ventricular dysfunction, ventricular tachyarrhythmia and SCD[\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Thus, markers of inflammation serve as biomarkers for the disease severity and adverse outcomes of HCM patients.\u003c/p\u003e \u003cp\u003eAlbumin is a hepatic protein and usually acts as a negative acute-phase protein. Its plasma concentration is mainly influenced by several factors, including the rate of albumin synthesis, catabolism, and loss by renal. Histological studies supported low serum albumin level are linked to adverse outcomes of cardiovascular disease, including heart failure, atrial fibrillation, ischemic heart disease, myocardial infarction, stroke and venous thromboembolism[\u003cspan additionalcitationids=\"CR27\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. In our cohort study, the level of AST and creatinine between the two groups was not significantly difference, which indicated there were no significant difference about the liver function and renal function between the two groups patients. Therefore, the main factors affecting serum albumin are inflammation and malnutrition in these patients. In addition, some studies have showed that malnutrition and inflammation played a major role in occurrence of low serum albumin levels [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] and the influence of inflammation on serum albumin levels seems to be stronger[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Fibrinogen, a positive acute-phase protein, produced in the liver upon stimulation of interleukin (IL)-6 and IL-1β, and its level increases in response to wound healing, infection, and inflammation[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Several studies have confirmed that plasma fibrinogen is a predictor of cardiovascular disease[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. AFR, a novel inflammatory biomarker, has been widely proposed as a prognostic marker in various diseases[\u003cspan additionalcitationids=\"CR10 CR11 CR12\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. AFR takes serum albumin (a negative acute-phase protein) and fibrinogen (a positive acute-phase protein) into account, it could better reflect the status of inflammation than alone. Gabay et al[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e] found anemia and hypoalbuminemia due to inflammation are common among hospitalized patients. In our study, patients with lower AFR value had lower levels of Hgb and albumin, which demonstrating the presence of inflammation in these patients indirectly. Despite the lack of diagnostic specificity, AFR is still a useful indicator as its changes reflect the presence of inflammatory process of patients. Modulating inflammatory reactions in HCM patients may be a useful therapeutic approach for managing myocardial fibrosis and adverse outcome.\u003c/p\u003e \u003cp\u003eThe study has several limitations. Firstly, this was a single center, retrospective study, and those patients were from China, lack of region diversification and race comparison. Secondly, the most widely used inflammatory indicators including the plasma C-reactive protein concentration, erythrocyte sedimentation rate, or IL-6 were not determined, thus the correlations between AFR and well-established inflammation indicators are missing. Thirdly, we did not collect some known markers, such as non-sustained ventricular tachycardia, for HCM-related adverse outcomes, and this might partly result in the biases of the results. Finally, AFR was evaluated only initial evaluation, whether the dynamic changes of AFR could still predict HCM-related death is unclear. However, AFR is a simple and inexpensive routine laboratory test, which provides relevant prognostic information in patients with HCM. It could help with the risk stratification, follow-up facilitation and more aggressive treatment. Therefore, AFR should serve as a potential screening tool to identify individuals at higher risk for adverse outcomes.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThe present study indicated that AFR is an independent prognostic factor for HCM-related death, a lower AFR is associated with increased risk of HCM-related death in adult HCM patients. It is unknown whether prevention and correction of low AFR could improve outcome of patients with HCM, further prospective studies are needed to assess the relationship between AFR and the prognosis of HCM.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHCM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ehypertrophic cardiomyopathy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAFR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ealbumin to fibrinogen ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSCD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003esudden cardiac death\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTE\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ethrombo-embolic event\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLVEDD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eleft ventricular end-diastolic dimension\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLAD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eleft atrial diameter\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMWT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003emaximal left ventricular wall thickness\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLVEF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eleft ventricular ejection fraction\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLVOTG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eleft ventricular outflow tract gradient\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHgb\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ehemoglobin\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePLT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePlatelet count\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWBCC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ewhite blood cell count\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHDL-C\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ehigh density lipoprotein cholesterin\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLDL-C\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003elow density lipoprotein cholesterin\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgment \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank all staff members for data collection, data entry and monitoring as part of this study and all funding sources.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSH conceived and supervised the study and performed statistical analysis of the data. LY was involved in the procedure and wrote the main body of the manuscript. CB participated in the discussion on the interpretation of the research content and took part in the procedure. YZ revised this paper. HY, MX, ZQ and MM participated in data collection. All authors critically revised and approved the final version of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was supported by Sichuan Science and Technology Program, China (Grant No. 2022YFS0186), and the National Natural Science Foundation of China (Grant No. 81600299).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was waived due to the retrospective nature of the study. It was approved by the Biomedical Research Ethics Committee, West China Hospital of Sichuan University (approval number: 2019-1147).\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eOmmen SR, et al. 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: Executive Summary. Circulation. 2020, 142(25): e533-57.\u003c/li\u003e\n\u003cli\u003eEsposito A, et al. Prevalence and clinical implications of hyperhomocysteinaemia in patients with hypertrophic cardiomyopathy and MTHFR C6777T polymorphism. Eur J Prev Cardiol. 2020, 27(17):1906-8.\u003c/li\u003e\n\u003cli\u003eMaron BJ, Maron MS, Rowin EJ. Perspectives on the Overall Risks of Living With Hypertrophic Cardiomyopathy. Circulation. 2017, 135(24):2317-9.\u003c/li\u003e\n\u003cli\u003eHo CY, et al. Genotype and Lifetime Burden of Disease in Hypertrophic Cardiomyopathy. Circulation. 2018, 138(14):1387-98.\u003c/li\u003e\n\u003cli\u003eBecker RC, Owens AP, Sadayappan S. Tissue-level inflammation and ventricular remodeling in hypertrophic cardiomyopathy. J Thromb Thrombolysis. 2020, 49(2):177-83.\u003c/li\u003e\n\u003cli\u003eMonda E, et al. Molecular Basis of Inflammation in the Pathogenesis of Cardiomyopathies. Int J Mol Sci. 2020, 21(18):6462.\u003c/li\u003e\n\u003cli\u003eZhu L, et al. Prognostic Significance of Plasma High-Sensitivity C-Reactive Protein in Patients With Hypertrophic Cardiomyopathy. J Am Heart Assoc. 2017, 6(2):e004529.\u003c/li\u003e\n\u003cli\u003eFang L, et al. Systemic inflammation is associated with myocardial fibrosis, diastolic dysfunction, and cardiac hypertrophy in patients with hypertrophic cardiomyopathy. Am J Transl Res. 2017, 9(11):5063-73.\u003c/li\u003e\n\u003cli\u003eTai H, et al. Albumin-to-Fibrinogen Ratio Independently Predicts 28-Day Mortality in Patients with Peritonitis-Induced Sepsis. Mediators Inflamm. 2020, 2020:7280708.\u003c/li\u003e\n\u003cli\u003eXiao L, et al. The impact of preoperative fibrinogen-albumin ratio on mortality in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Clin Chim Acta. 2019, 493:8-13.\u003c/li\u003e\n\u003cli\u003eRuan Y, et al. High fibrinogen-to-albumin ratio is associated with hemorrhagic transformation in acute ischemic stroke patients. Brain Behav. 2021, 11(1):e01855.\u003c/li\u003e\n\u003cli\u003eYou X, et al. Preoperative albumin-to-fibrinogen ratio predicts severe postoperative complications in elderly gastric cancer subjects after radical laparoscopic gastrectomy. BMC Cancer. 2019, 19(1):931.\u003c/li\u003e\n\u003cli\u003eLi S, et al. Prognostic Value of Preoperative Albumin-to-Fibrinogen Ratio in Patients with Bladder Cancer. J Cancer. 2021, 12(19):5864-73.\u003c/li\u003e\n\u003cli\u003eGao K, et al. Novel inflammatory markers in the blood of patients with knee synovitis. J Int Med Res. 2021, 49(7): 3000605211029557.\u003c/li\u003e\n\u003cli\u003eLang RM, et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogra. 2015, 28(1):1-39.e14.\u003c/li\u003e\n\u003cli\u003eElliott PM, et al. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy The Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J. 2014, 35(39):2733-79.\u003c/li\u003e\n\u003cli\u003eWang Z, Zhao L, He S. Prognostic nutritional index and the risk of mortality in patients with hypertrophic cardiomyopathy. Int J Cardiol. 2021, 331:152-7.\u003c/li\u003e\n\u003cli\u003eLiao H, et al. Myocardial contraction fraction predicts mortality for patients with hypertrophic cardiomyopathy. Sci Rep. 2020,10(1):17026.\u003c/li\u003e\n\u003cli\u003eMaron BJ, Maron MS. Hypertrophic cardiomyopathy. Lancet. 2013, 381(9862):242-55.\u003c/li\u003e\n\u003cli\u003eHogye M, et al. Comparison of circulating levels of interleukin-6 and tumor necrosis factor-alpha in hypertrophic cardiomyopathy and in idiopathic dilated cardiomyopathy. Am J Cardiol. 2004, 94(2):249-51.\u003c/li\u003e\n\u003cli\u003eZen K, et al. Analysis of circulating apoptosis mediators and proinflammatory cytokines in patients with idiopathic hypertrophic cardiomyopathy - Comparison between nonobstructive and dilated-phase hypertrophic cardiomyopathy. Int Heart J. 2005, 46(2):231-44.\u003c/li\u003e\n\u003cli\u003ePiek A, de Boer RA, Sillje HHW. The fibrosis-cell death axis in heart failure. Heart Fail Rev. 2016,21(2):199-211.\u003c/li\u003e\n\u003cli\u003eHo CY, et al. Myocardial Fibrosis as an Early Manifestation of Hypertrophic Cardiomyopathy. N Engl J Med. 2010, 363(6):552-63.\u003c/li\u003e\n\u003cli\u003eVarnava AM, et al. Hypertrophic cardiomyopathy: the interrelation of disarray, fibrosis, and small vessel disease. Heart. 2000, 84(5):476-82.\u003c/li\u003e\n\u003cli\u003eAdabag AS, et al. Occurrence and frequency of arrhythmias in hypertrophic cardiomyopathy on relation to delayed enhancement on cardiovascular magnetic resonance. J Am Coll Cardiol. 2008, 51(14):1369-74.\u003c/li\u003e\n\u003cli\u003eArques S. Human serum albumin in cardiovascular diseases. Eur J Intern Med. 2018, 52:8-12.\u003c/li\u003e\n\u003cli\u003eArques S, Ambrosi P. Human Serum Albumin in the Clinical Syndrome of Heart Failure. J Card Fail. 2011, 17(6):451-8.\u003c/li\u003e\n\u003cli\u003eDjousse L, et al. Serum albumin and risk of myocardial infarction and all-cause mortality in the Framingham Offspring Study. Circulation. 2002, 106(23):2919-24.\u003c/li\u003e\n\u003cli\u003eWada H, et al. Impact of serum albumin levels on long-term outcomes in patients undergoing percutaneous coronary intervention. Heart Vessels. 2017, 32(9):1085-92.\u003c/li\u003e\n\u003cli\u003eEckart A, et al. Relationship of Nutritional Status, Inflammation, and Serum Albumin Levels During Acute Illness: A Prospective Study. Am J Med. 2020, 133(6):713-22.\u003c/li\u003e\n\u003cli\u003eKaysen GA, et al. Inflammation and reduced albumin synthesis associated with stable decline in serum albumin in hemodialysis patients. Kidney Int. 2004, 65(4):1408-15.\u003c/li\u003e\n\u003cli\u003eTennent GA, et al. Human plasma fibrinogen is synthesized in the liver. Blood. 2007, 109(5):1971-4.\u003c/li\u003e\n\u003cli\u003eYamaguchi T, et al. Involvement of interleukin-6 in the elevation of plasma fibrinogen levels in lung cancer patients. Japan J Clin Oncol. 1998, 28(12):740-4.\u003c/li\u003e\n\u003cli\u003eDeveci B, Gazi E. Relation Between Globulin, Fibrinogen, and Albumin With the Presence and Severity of Coronary Artery Disease. Angiology. 2021, 72(2):174-80.\u003c/li\u003e\n\u003cli\u003eKannel WB, et al. Fibrinogen and risk of cardiovascular disease. The Framingham Study. JAMA. 1987, 258(9):1183-6.\u003c/li\u003e\n\u003cli\u003eGabay C, Kushner I. Mechanisms of disease: Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999, 340(6):448-54.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"955\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" style=\"width: 68.6307%;\" width=\"98.32460732984293%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1.\u0026nbsp;\u003c/strong\u003eBaseline characteristics.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003eAll (n=404)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003eLow AFR (n=202)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003eHigh AFR (n=202)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003ep value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;57.00 (46.00, 67.00)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;60.00 (49.00, 68.75)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;53.00 (42.25, 65.00) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026lt;0.001 \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eGender, male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 220 (54.46%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 95 (47.03%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 125 (61.88%) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.004 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eFamily history of HCM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;36 (8.91%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;19 (9.41%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;17 (8.42%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.861 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eFamily history of SCD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;14 (3.47%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;6 (2.97%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;8 (3.96%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.786 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eNYHA III-IV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 143 (35.40%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 84 (41.58%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 59 (29.21%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.013 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eSBP (mmHg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e120.00 (110.00, 136.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e120.00 (108.00, 140.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e120.00 (110.00, 132.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.468 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eDBP (mmHg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;71.00 (65.00, 80.00) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;70.00 (64.00, 80.00) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;74.00 (65.25, 80.00) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.305 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eSmoke\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 137 (33.91%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 67 (33.17%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 70 (34.65%) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.834 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eSymptom\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eDyspnea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 237 (58.66%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 123 (60.89%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 114 (56.44%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.419 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eChest pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 233 (57.67%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 113 (55.94%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 120 (59.41%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.546 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eSyncope/pre-syncope\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 136 (33.66%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 65 (32.18%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 71 (35.15%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.599 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003ePalpitation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 159 (39.36%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 79 (39.11%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 80 (39.60%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;1.000 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eMedical history\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003ePrior TE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;20 (4.95%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;11 (5.45%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;9 (4.46%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.819 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eVascular diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;34 (8.42%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;18 (8.91%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;16 (7.92%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.858 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 130 (32.18%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 75 (37.13%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 55 (27.23%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.043 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eDiabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;29 (7.18%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;17 (8.42%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;12 (5.94%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.441 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eAtrial fibrillation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 77 (19.06%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 35 (17.33%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 42 (20.79%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.447 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eTherapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eAspirin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 77 (19.06%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 39 (19.31%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 38 (18.81%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;1.000 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eClopidogrel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;26 (6.44%) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;13 (6.44%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;13 (6.44%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;1.000 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eWarfarin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 41 (10.15%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;20 (9.90%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 21 (10.40%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;1.000 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eBeta blockers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 305 (75.50%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 147 (72.77%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 158 (78.22%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.247 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eACEI or ARB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 86 (21.29%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 48 (23.76%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 38 (18.81%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.274 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eIntervention of obstruction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.134 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;None\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 356 (88.12%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 184 (91.09%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 172 (85.15%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Alcohol septal ablation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 42 (10.40%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;15 (7.43%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 27 (13.37%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Septal myectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;6 (1.49%) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;3 (1.49%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;3 (1.49%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eDevice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.650 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;None\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 354 (87.62%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 179 (88.61%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 175 (86.63%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Pacemaker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;17 (4.21%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;9 (4.46%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;8 (3.96%) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003e\u0026nbsp; ICD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;33 (8.17%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;14 (6.93%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;19 (9.41%) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eEchocardiographic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eLVEDD (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;43.00 (40.00, 47.00) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;43.00 (39.00, 47.00)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;43.00 (40.00, 47.00) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.729 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eLAD (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;40.00 (36.00, 45.00) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;40.00 (36.00, 45.00) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;41.00 (36.00, 45.75) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.220 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eMWT (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;19.00 (17.00, 22.00) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;19.00 (16.00, 21.00) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;20.00 (17.00, 23.00) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.003 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eLVEF (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;68.00 (63.00, 72.00) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;68.00 (63.00, 72.00) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;69.00 (64.00, 72.75)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.389 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eResting LVOTG\u0026nbsp;\u0026ge;\u0026nbsp;30 mm Hg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 0.43 (0.50) \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 0.43 (0.50) \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 0.43 (0.50) \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;1.000 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eLaboratory tests\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eHgb (g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e138.50 (126.75, 151.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e135.00 (123.00, 146.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e143.00 (131.00, 154.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026lt;0.001 \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003ePLT (10\u003csup\u003e9\u003c/sup\u003e/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e146.00 (110.00, 186.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e153.00 (113.00, 198.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e141.00 (108.25, 173.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.024 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eWBCC (10\u003csup\u003e9\u003c/sup\u003e/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 6.31 (5.20, 7.71）\u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 6.46 (5.34, 8.31) \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 6.12 (5.10, 7.27) \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.017 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eAlbumin (g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;42.40 (39.88, 45.02)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;41.25 (38.45, 43.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;43.65 (41.70, 46.30) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026lt;0.001 \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eALT (IU/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;23.00 (16.00, 34.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;21.00 (15.00, 33.00) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;24.00 (18.00, 34.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.020 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eAST (IU/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;26.00 (21.00, 32.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;26.00 (20.00, 33.00) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;26.00 (21.00, 32.00) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.814 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eGlucose (mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 5.44 (4.88, 6.43) \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 5.42 (4.88, 6.53) \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 5.46 (4.89, 6.33) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.723 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" valign=\"top\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eCreatinine (\u0026mu;mol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;80.60 (67.22, 94.03) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;81.00 (66.03, 96.00)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp;80.25 (68.40, 92.40)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.837 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eTG (mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 1.26 (0.96, 1.87) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 1.25 (0.93, 1.70) \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 1.28 (0.97, 1.98) \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.187 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eTC (mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 4.28 (3.56, 4.82) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 4.28 (3.64, 4.82) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 4.26 (3.50, 4.82) \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.652 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eHDL-C (mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 1.27 (1.03, 1.54) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 1.29 (1.02, 1.56) \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 1.26 (1.03, 1.51) \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.668 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eLDL-C (mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 2.43 \u0026plusmn; 0.76 \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 2.42 \u0026plusmn; 0.76 \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 2.44 \u0026plusmn; 0.76 \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.841 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4572%;\" width=\"26.701570680628272%\"\u003e\n \u003cp\u003eFibrinogen (g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 2.65 (2.26, 3.28) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 3.28 (2.87, 3.70) \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0124%;\" width=\"20.31413612565445%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 2.26 (2.02, 2.47) \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.9856%;\" width=\"10.680628272251308%\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026lt;0.001 \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" style=\"width: 68.6307%;\" valign=\"top\" width=\"98.32460732984293%\"\u003e\n \u003cp\u003eValues are mean \u0026plusmn; SD or median (IQR) or n (%).\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eHCM = hypertrophic cardiomyopathy, AFR = albumin to fibrinogen ratio, SCD = sudden cardiac death, NYHA = New York Heart Association, SBP = systolic blood pressure, DBP = diastolic blood pressure, TE = thrombo-embolic event, ACEI = angiotensin-converting enzyme inhibitor , ARB = angiotensin receptor blocker, ICD = implantable cardioverter defibrillator, LVEDD = left ventricular end-diastolic dimension, LAD = left atrial diameter, MWT = maximal left ventricular wall thickness, LVEF = left ventricular ejection fraction, LVOTG = left ventricular outflow tract gradient, Hgb = hemoglobin, PLT = Platelet count, WBCC = white blood cell count, ALT = alanine aminotransferase, AST = aspartate aminotransferase, TG = triglyceride, TC = Cholesterol, HDL-C = high density lipoprotein cholesterin, LDL-C = low density lipoprotein cholesterin.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"640\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" width=\"100%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2.\u0026nbsp;\u003c/strong\u003eAssociations of AFR with HCM-related death.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.101404056162245%\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"29.485179407176286%\"\u003e\n \u003cp\u003eHigh AFR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.413416536661465%\"\u003e\n \u003cp\u003eLow AFR\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.101404056162245%\"\u003e\n \u003cp\u003eNo. of patients (n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"29.485179407176286%\"\u003e\n \u003cp\u003e202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.413416536661465%\"\u003e\n \u003cp\u003e202\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.101404056162245%\"\u003e\n \u003cp\u003eEndpoints (n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"29.485179407176286%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.413416536661465%\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.101404056162245%\"\u003e\n \u003cp\u003eFollow-up (PYs)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"29.485179407176286%\"\u003e\n \u003cp\u003e995.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.413416536661465%\"\u003e\n \u003cp\u003e904.51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.37753510140406%\"\u003e\n \u003cp\u003eMortality rates\u003csup\u003e⁎\u003c/sup\u003e (95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"26.209048361934478%\"\u003e\n \u003cp\u003e1.2 (0.5-1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.413416536661465%\"\u003e\n \u003cp\u003e3.6 (2.4-4.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.101404056162245%\"\u003e\n \u003cp\u003eUnadjusted HRs (95% CI), p\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"29.485179407176286%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.413416536661465%\"\u003e\n \u003cp\u003e2.97 (0.17-0.65), 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.101404056162245%\"\u003e\n \u003cp\u003eAdjusted HRs (95% CI), p\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"29.485179407176286%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"35.413416536661465%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.101404056162245%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; model 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"29.485179407176286%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.413416536661465%\"\u003e\n \u003cp\u003e2.80 (0.18-0.70), 0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.101404056162245%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; model 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"29.485179407176286%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.413416536661465%\"\u003e\n \u003cp\u003e3.15 (0.16-0.64), 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003e⁎\u003c/sup\u003ePer 100 PYs, PYs = person-years, CI = confidence interval, HRs = hazard ratios.\u003c/p\u003e\n\u003cp\u003eModel 1 with adjustment for age and gender.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eModel 2 with adjustment for age, gender, dyspnea, NYHA III-IV, family history of SCD, AF, AST, TG, MWT, and resting LVOTO.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbbreviations as in table 1.\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"718\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"100%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 3.\u003c/strong\u003e Stratified analyses of HCM-related death.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" width=\"19.080779944289695%\"\u003e\n \u003cp\u003eSubgroups\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\n \u003cp\u003eLow AFR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\n \u003cp\u003eHigh AFR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\n \u003cp\u003e\u0026nbsp;Adjusted HRs (95% CI), p\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.09192200557103%\"\u003e\n \u003cp\u003ep for interaction\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" width=\"100%\"\u003e\n \u003cp\u003eHCM-related death / Total patients.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.09192200557103%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\n \u003cp\u003e16/95 (16.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\n \u003cp\u003e5/125 (4.00%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\n \u003cp\u003e4.96 (0.07-0.62), 0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"13.09192200557103%\"\u003e\n \u003cp\u003e0.678\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.955128205128204%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.352564102564102%\"\u003e\n \u003cp\u003e17 /107 (15.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.756410256410255%\"\u003e\n \u003cp\u003e7/77 (9.09%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.93589743589744%\"\u003e\n \u003cp\u003e3.70 (0.10-0.73), 0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.09192200557103%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026lt;57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\n \u003cp\u003e11/77 (14.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\n \u003cp\u003e\u0026nbsp;7/116 (6.03%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\n \u003cp\u003e3.07 (0.12-0.90), 0.030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"13.09192200557103%\"\u003e\n \u003cp\u003e0.615\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.955128205128204%\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026ge;57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.352564102564102%\"\u003e\n \u003cp\u003e22/125 (17.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.756410256410255%\"\u003e\n \u003cp\u003e5/86 (5.81%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.93589743589744%\"\u003e\n \u003cp\u003e4.13 (0.08-0.72), 0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.080779944289695%\"\u003e\n \u003cp\u003eNYHA III-IV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.09192200557103%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003e\u0026nbsp; No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\n \u003cp\u003e15/118 (12.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\n \u003cp\u003e7/143 (4.90%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\n \u003cp\u003e3.96 (0.09-0.70), 0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"13.09192200557103%\"\u003e\n \u003cp\u003e0.881\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.955128205128204%\"\u003e\n \u003cp\u003e\u0026nbsp; Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.352564102564102%\"\u003e\n \u003cp\u003e18/84 (21.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.756410256410255%\"\u003e\n \u003cp\u003e5/59 (8.47%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.93589743589744%\"\u003e\n \u003cp\u003e3.14 (0.11-0.93), 0.037\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.09192200557103%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003e\u0026nbsp; No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\n \u003cp\u003e23/127 (18.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\n \u003cp\u003e10/147 (6.80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\n \u003cp\u003e3.19 (0.14-0.70), 0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"13.09192200557103%\"\u003e\n \u003cp\u003e0.676\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.955128205128204%\"\u003e\n \u003cp\u003e\u0026nbsp; Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.352564102564102%\"\u003e\n \u003cp\u003e10/75 (13.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.756410256410255%\"\u003e\n \u003cp\u003e2/55 (3.64%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.93589743589744%\"\u003e\n \u003cp\u003e4.54 (0.04-1.24), 0.086\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003eAF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.09192200557103%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003e\u0026nbsp; No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\n \u003cp\u003e21/167 (12.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\n \u003cp\u003e3/160 (1.88%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\n \u003cp\u003e6.51 (0.04-0.53), 0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"13.09192200557103%\"\u003e\n \u003cp\u003e0.144\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.955128205128204%\"\u003e\n \u003cp\u003e\u0026nbsp; Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.352564102564102%\"\u003e\n \u003cp\u003e12/35 (34.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.756410256410255%\"\u003e\n \u003cp\u003e9/42 (21.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.93589743589744%\"\u003e\n \u003cp\u003e2.72 (0.13-1.06), 0.065\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003eWarfarin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.09192200557103%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003e\u0026nbsp; No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\n \u003cp\u003e26/182 (14.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\n \u003cp\u003e7/181 (3.87%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\n \u003cp\u003e3.76 (0.11-0.64), 0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"13.09192200557103%\"\u003e\n \u003cp\u003e0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.955128205128204%\"\u003e\n \u003cp\u003e\u0026nbsp; Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.352564102564102%\"\u003e\n \u003cp\u003e7/20 (35.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.756410256410255%\"\u003e\n \u003cp\u003e5/21 (23.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.93589743589744%\"\u003e\n \u003cp\u003e2.96 (0.02-4.89), 0.426\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.080779944289695%\"\u003e\n \u003cp\u003eBeta blockers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.09192200557103%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003e\u0026nbsp; No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\n \u003cp\u003e9/55 (16.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\n \u003cp\u003e4/44 (9.09%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\n \u003cp\u003e2.10 (0.12-1.87), 0.288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"13.09192200557103%\"\u003e\n \u003cp\u003e0.484\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.955128205128204%\"\u003e\n \u003cp\u003e\u0026nbsp; Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.352564102564102%\"\u003e\n \u003cp\u003e24/147 (16.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.756410256410255%\"\u003e\n \u003cp\u003e8/158 (5.06%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.93589743589744%\"\u003e\n \u003cp\u003e4.99 (0.08-0.51), \u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.080779944289695%\"\u003e\n \u003cp\u003eHgb (g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.09192200557103%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026lt;138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\n \u003cp\u003e23/114 (20.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\n \u003cp\u003e6/74 (8.11%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\n \u003cp\u003e4.12 (0.09-0.68), 0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"13.09192200557103%\"\u003e\n \u003cp\u003e0.523\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.955128205128204%\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026ge;138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.352564102564102%\"\u003e\n \u003cp\u003e10/88 (11.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.756410256410255%\"\u003e\n \u003cp\u003e6/128 (4.69%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.93589743589744%\"\u003e\n \u003cp\u003e2.72 (0.12-1.13), 0.081\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.080779944289695%\"\u003e\n \u003cp\u003eAST (IU/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.09192200557103%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026lt;26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\n \u003cp\u003e9/100 (9.00%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\n \u003cp\u003e3/96 (3.12%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\n \u003cp\u003e\u0026nbsp;3.24 (0.07-1.42), 0.131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"13.09192200557103%\"\u003e\n \u003cp\u003e0.237\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.955128205128204%\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026ge;26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.352564102564102%\"\u003e\n \u003cp\u003e24/102 (23.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.756410256410255%\"\u003e\n \u003cp\u003e9/106 (8.49%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.93589743589744%\"\u003e\n \u003cp\u003e3.26 (0.14-0.69), 0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.080779944289695%\"\u003e\n \u003cp\u003eTG (mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.09192200557103%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026lt;1.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\n \u003cp\u003e20/104 (19.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\n \u003cp\u003e8/96 (8.33%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\n \u003cp\u003e3.01 (0.13-0.85), 0.021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"13.09192200557103%\"\u003e\n \u003cp\u003e0.148\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.955128205128204%\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026ge;1.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.352564102564102%\"\u003e\n \u003cp\u003e13/98 (13.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.756410256410255%\"\u003e\n \u003cp\u003e4/106 (3.77%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.93589743589744%\"\u003e\n \u003cp\u003e7.17 (0.03-0.59), 0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.080779944289695%\"\u003e\n \u003cp\u003eLVEDD (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.09192200557103%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026lt;43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\n \u003cp\u003e20/97 (20.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\n \u003cp\u003e9/96 (9.38%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\n \u003cp\u003e2.51 (0.17-0.92), 0.031\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"13.09192200557103%\"\u003e\n \u003cp\u003e0.181\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.955128205128204%\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026ge;43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.352564102564102%\"\u003e\n \u003cp\u003e13/105 (12.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.756410256410255%\"\u003e\n \u003cp\u003e3/106 (2.83%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.93589743589744%\"\u003e\n \u003cp\u003e4.81 (0.05-0.90), 0.036\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"19.080779944289695%\"\u003e\n \u003cp\u003eLVEF (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.09192200557103%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.080779944289695%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026lt;68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.688022284122564%\"\u003e\n \u003cp\u003e15/93 (16.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.77715877437326%\"\u003e\n \u003cp\u003e9/90 (10.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.362116991643454%\"\u003e\n \u003cp\u003e2.02 (0.19-1.26), 0.141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"13.09192200557103%\"\u003e\n \u003cp\u003e0.467\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.955128205128204%\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026ge;68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.352564102564102%\"\u003e\n \u003cp\u003e18/109 (16.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.756410256410255%\"\u003e\n \u003cp\u003e3/112 (2.68%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.93589743589744%\"\u003e\n \u003cp\u003e5.56 (0.05-0.66), 0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: Each stratification adjusted for age, gender, dyspnea, NYHA class, AF, AST, TG, LVEDD, LVEF, Resting LVOTG\u0026nbsp;\u0026ge;\u0026nbsp;30 mm Hg, except the stratification factor itself.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbbreviations as in tables 1 and 2.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-cardiovascular-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcar","sideBox":"Learn more about [BMC Cardiovascular Disorders](http://bmccardiovascdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcar/default.aspx","title":"BMC Cardiovascular Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"albumin, fibrinogen, hypertrophic cardiomyopathy, prognosis, inflammation","lastPublishedDoi":"10.21203/rs.3.rs-2547038/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2547038/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eAlbumin to fibrinogen ratio (AFR) has emerged as a useful indicator for adverse outcomes in several diseases. However, whether the AFR could be a new useful indicator to predict mortality in HCM patients remains to be evaluated. The study investigated the predictive value of the AFR for HCM-related death in adult HCM patients.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA total of 404 HCM patients were retrospectively enrolled. Patients were divided into two groups based on the median of baseline AFR. The association between AFR and HCM-related death was analyzed.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eDuring a median follow-up duration of 4.75 years, 45 patients (11.1%) occurred in HCM-related death. The incidence of HCM-related death was significantly higher in the low AFR group (Log-rank p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). With the high AFR group as reference, the fully adjusted hazard ratios (HRs) of HCM-related death were 3.15 for the low AFR group (95% confidence interval [CI]: 0.16\u0026ndash;0.64, p\u0026thinsp;=\u0026thinsp;0.001). No significant interactions between AFR and other variables were observed in subgroup analysis. Sensitivity analyses in patients with normal albumin and fibrinogen have showed similar results.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eAFR is an independent prognostic factor for HCM-related death in adult HCM patients.\u003c/p\u003e","manuscriptTitle":"Prognostic value of albumin to fibrinogen ratio for mortality in patients with hypertrophic cardiomyopathy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-02-16 15:23:34","doi":"10.21203/rs.3.rs-2547038/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2023-06-09T13:11:43+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"a9c2ec40-c786-4b74-9686-b745f591e38c","date":"2023-06-01T08:55:11+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2023-05-31T17:55:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"b1968381-49ad-4045-ab92-f43c1e5a25d7","date":"2023-05-12T18:39:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"dd9dff71-8f5b-4f25-8fea-39fdf591e8cd","date":"2023-05-11T10:15:34+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"d6005aa2-6f41-43eb-96a5-4dd87184bcd7","date":"2023-03-26T23:26:46+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2023-03-24T01:13:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"b06743c0-9753-45c1-a51c-3aad4bbd1edc","date":"2023-03-24T00:11:24+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2023-03-16T11:54:02+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2023-02-27T07:40:39+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2023-02-15T10:33:54+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2023-02-15T10:29:53+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Cardiovascular Disorders","date":"2023-02-03T13:39:56+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-cardiovascular-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcar","sideBox":"Learn more about [BMC Cardiovascular Disorders](http://bmccardiovascdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcar/default.aspx","title":"BMC Cardiovascular Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"db583113-3c23-4c0e-8291-fe4bc22f438b","owner":[],"postedDate":"February 16th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2023-11-20T15:05:49+00:00","versionOfRecord":{"articleIdentity":"rs-2547038","link":"https://doi.org/10.1186/s12872-023-03562-8","journal":{"identity":"bmc-cardiovascular-disorders","isVorOnly":false,"title":"BMC Cardiovascular Disorders"},"publishedOn":"2023-11-16 15:01:08","publishedOnDateReadable":"November 16th, 2023"},"versionCreatedAt":"2023-02-16 15:23:34","video":"","vorDoi":"10.1186/s12872-023-03562-8","vorDoiUrl":"https://doi.org/10.1186/s12872-023-03562-8","workflowStages":[]},"version":"v1","identity":"rs-2547038","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2547038","identity":"rs-2547038","version":["v1"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}