PO-07-051 RISK STRATIFICATION IN MIDDLE-AGED AND OLDER ADULTS WITH HYPERTROPHIC CARDIOMYOPATHY: INSIGHTS FROM THE SARCOMERIC HUMAN CARDIOMYOPATHY REGISTRY (SHARE)

Background Hypertrophic cardiomyopathy (HCM) in older adults poses unique challenges for risk stratification, with limited data on arrhythmic risk and ICD utility. It remains uncertain whether established risk assessment tools apply to patients presenting at older age and how risks differ based on sarcomeric versus non-sarcomeric status. Objective To evaluate arrhythmic risk in older patients with HCM across different genotypic/familial status and examine the predictive value of standard markers across different age subgroups. Methods We conducted a retrospective analysis of patients with HCM through the prospectively-collected, multicenter, international SHaRe database. Stratification was performed according to presenting age for evaluation (≥50 years vs. <50 years) defined at entry into database. The primary outcome was defined as sustained VT/VF, appropriate ICD therapy, or sudden cardiac death (SCD). Predictive value of age at diagnosis (>40 years vs. ≤40 years), of familial HCM (family history of HCM or P/LP sarcomeric mutation) vs. non-familial HCM, and of high versus low ESC SCD score was evaluated by presenting age for evaluation. Kaplan-Meier curves and Cox regression assessed event risk.