{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T01:45:40Z","timestamp":1790214340328,"version":"4.1.0"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Genomic and Precision Medicine"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Females with hypertrophic cardiomyopathy present at a more advanced stage of the disease and have a higher risk of heart failure and death. The factors behind these differences are unclear. We aimed to investigate sex-related differences in clinical and genetic factors affecting adverse outcomes in the Sarcomeric Human Cardiomyopathy Registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Cox proportional hazard models were fit with a sex interaction term to determine if significant sex differences existed in the association between risk factors and outcomes. Models were fit separately for females and males to find the sex-specific hazard ratio (HR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      After a mean follow-up of 6.4 years, females had a higher risk of heart failure (HR, 1.51 [95% CI, 1.21\u20131.88];\n                      <jats:italic>P<\/jats:italic>\n                      =0.0003) but a lower risk of atrial fibrillation (HR, 0.74 [95% CI, 0.59\u20130.93];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001) and ventricular arrhythmia (HR, 0.60 [95% CI, 0.38\u20130.94];\n                      <jats:italic>P<\/jats:italic>\n                      =0.027) than males. No sex difference was observed for death (\n                      <jats:italic>P<\/jats:italic>\n                      =0.84). Sarcomere-positive males had higher heart failure (HR, 1.34 [95% CI, 1.06\u20131.69]) and death risks (HR, 1.48 [95% CI, 1.08\u20132.04]) not seen in females (HR, 0.85 [95% CI, 0.66\u20131.08] versus HR, 0.86 [95% CI, 0.71\u20131.21]).\n                      <jats:italic>MYBPC3<\/jats:italic>\n                      variants lowered heart failure risk in females (HR, 0.56 [95% CI, 0.41\u20130.77]) but not in males (HR, 1.29 [95% CI, 0.99\u20131.67]). A sex difference appeared in moderate (4% to &lt;6%) versus low risk (&lt;4%) European Society of Cardiology hypertrophic cardiomyopathy risk score, with females at moderate risk more prone to ventricular arrhythmia (HR, 3.57 [95% CI, 1.70\u20137.49]), unobserved in males (HR, 1.13 [95% CI, 0.63\u20132.03]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>We found that clinical and genetic factors contributing to adverse outcomes in hypertrophic cardiomyopathy affect females and males differently. Thus, research to inform sex-specific management of hypertrophic cardiomyopathy could improve outcomes for both sexes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circgen.124.004641","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T05:00:45Z","timestamp":1737694845000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Sex-Specific Clinical and Genetic Factors Associated With Adverse Outcomes in Hypertrophic Cardiomyopathy"],"prefix":"10.1161","volume":"18","author":[{"given":"Alexandra","family":"Butters","sequence":"first","affiliation":[{"name":"Genomics and Inherited Disease Program, Garvan Institute of Medical Research (A.B., J.S., J.I.), University of New South Wales, Sydney, Australia."},{"name":"Faculty of Medicine and Health (A.B., C.S., J.I.), The University of Sydney, Camperdown, New South Wales, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9370-9913","authenticated-orcid":true,"given":"Clare","family":"Arnott","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health (C.A.), University of New South Wales, Sydney, Australia."},{"name":"Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia (C.A., C.S., J.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Sweeting","sequence":"additional","affiliation":[{"name":"Genomics and Inherited Disease Program, Garvan Institute of Medical Research (A.B., J.S., J.I.), University of New South Wales, Sydney, Australia."},{"name":"School of Clinical Medicine, Faculty of Medicine and Health (J.S., J.I.,), University of New South Wales, Sydney, 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