{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T17:43:04Z","timestamp":1783618984491,"version":"3.55.0"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2024,2,13]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Compared with men, women with hypertrophic cardiomyopathy (HCM) have a higher incidence of heart failure and worse outcomes. We investigated baseline clinical and echocardiographic characteristics and response to mavacamten among women compared with men in the EXPLORER-HCM study (Clinical Study to Evaluate Mavacamten [MYK-461] in Adults With Symptomatic Obstructive Hypertrophic Cardiomyopathy).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>\n              A prespecified post hoc analysis of sex from the blinded, randomized EXPLORER-HCM trial of mavacamten versus placebo in symptomatic patients with obstructive HCM was performed. Baseline characteristics were compared with\n              <jats:italic toggle=\"yes\">t<\/jats:italic>\n              tests for continuous variables (expressed as mean values) and \u03c7\n              <jats:sup>2<\/jats:sup>\n              tests for categorical variables. Prespecified primary, secondary, and exploratory end points and echocardiographic measurements from baseline to end of treatment (week 30) were analyzed with ANCOVA for continuous end points and a generalized linear model with binomial distribution for binary end points, with adjustment for each outcome's baseline value, New York Heart Association class, \u03b2-blocker use, and ergometer type.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              At baseline, women (n=102) were older (62 years versus 56 years;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.0001), had lower peak oxygen consumption (16.7 mL\u00b7kg\n              <jats:sup>\u22121<\/jats:sup>\n              \u00b7min\n              <jats:sup>\u22121<\/jats:sup>\n              versus 21.3 mL\u00b7kg\n              <jats:sup>\u22121<\/jats:sup>\n              \u00b7min\n              <jats:sup>\u22121<\/jats:sup>\n              ;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.0001), were more likely to be assigned New York Heart Association class III (42% versus 17%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.0001), had worse health status (Kansas City Cardiomyopathy Questionnaire\u2013Clinical Summary Score 64 versus 75;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.0001), and had higher baseline plasma NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels (1704 ng\/L versus 990 ng\/L;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.004) than men (n=149). After 30 weeks of mavacamten treatment, similar improvements were observed in women and men in the primary composite end point (percentage difference on mavacamten versus placebo, 22% versus 19%, respectively;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.759) and in the secondary end points of change in postexercise left ventricular outflow tract gradient (\u221242.4 mm\u2009Hg versus \u221233.6 mm\u2009Hg;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.348), change in peak oxygen consumption (1.2 mL\u00b7kg\n              <jats:sup>\u22121<\/jats:sup>\n              \u00b7min\n              <jats:sup>\u22121<\/jats:sup>\n              versus 1.6 mL\u00b7kg\n              <jats:sup>\u22121<\/jats:sup>\n              \u00b7min\n              <jats:sup>\u22121<\/jats:sup>\n              ;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.633), and percentage achieving \u22651 New York Heart Association class improvement (41% versus 28%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.254). However, women had greater improvement in health status (Kansas City Cardiomyopathy Questionnaire\u2013Clinical Summary Score 14.8 versus 6.1;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.026) and in the exploratory end point of NT-proBNP levels (\u22121322 ng\/L versus \u2212649 ng\/L;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.0008).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Although at baseline women with symptomatic obstructive HCM enrolled in EXPLORER-HCM were older and had worse heart failure and health status than men, treatment with mavacamten resulted in similar improvements in the primary and most secondary EXPLORER-HCM end points and greater improvements in health status and NT-proBNP.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT03470545.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.123.065600","type":"journal-article","created":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T10:00:17Z","timestamp":1699956017000},"page":"498-509","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Effect of Mavacamten in Women Compared With Men With Obstructive Hypertrophic Cardiomyopathy: Insights From EXPLORER-HCM"],"prefix":"10.1161","volume":"149","clinical-trial-number":[{"clinical-trial-number":"nct03470545","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5417-1054","authenticated-orcid":true,"given":"Sharon","family":"Cresci","sequence":"first","affiliation":[{"name":"Cardiovascular Division, Department of Medicine, (S.C., R.G.B.), Washington University School of Medicine, St Louis, MO."},{"name":"Department of Genetics (S.C.), Washington University School of Medicine, St Louis, MO."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard G.","family":"Bach","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Department of Medicine, (S.C., R.G.B.), Washington University School of Medicine, St Louis, MO."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4473-6725","authenticated-orcid":true,"given":"Sara","family":"Saberi","sequence":"additional","affiliation":[{"name":"University of Michigan, Ann Arbor (S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9669-8495","authenticated-orcid":true,"given":"Anjali T.","family":"Owens","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia (A.T.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2839-2611","authenticated-orcid":true,"given":"John A.","family":"Spertus","sequence":"additional","affiliation":[{"name":"University of Missouri\u2013Kansas City\u2019s Healthcare Institute for Innovations in Quality and Saint Luke\u2019s Mid America Heart Institute (J.A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8157-8899","authenticated-orcid":true,"given":"Sheila M.","family":"Hegde","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.M.H., N.K.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6458-5421","authenticated-orcid":true,"given":"Neal K.","family":"Lakdawala","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.M.H., N.K.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1719-6270","authenticated-orcid":true,"given":"Ester Kim","family":"Nilles","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (E.K.N., 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