Aficamten for Obstructive Hypertrophic Cardiomyopathy

Clinical Takeaway

: Another cardiac myosin inhibitor shows benefits for patients in hemodynamics, exercise capacity, and symptoms, compared with metoprolol.

Context

Patients with the obstructive phenotype of hypertrophic cardiomyopathy (HCM) often experience heart-failure symptoms and decreased exercise capacity, at least in part due to left-ventricular outflow tract (LVOT) obstruction, which is often worsened by exercise. Patients with symptomatic disease have shown improvement with the cardiac myosin inhibitor mavacamten (NEJM JW Cardiol Aug 30 2020 and Lancet 2020; 396:759). Now, in an international, multicenter, manufacturer-sponsored trial, researchers compared a beta blocker with a new, non–FDA-approved cardiac myosin inhibitor, aficamten, in 175 individuals with obstructive HCM (mean LVOT gradient, 47 mm Hg at rest; New York Heart Association [NYHA] class II, 70%) and normal left-ventricu…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, MACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)