{"doi":"10.1016/j.cjco.2025.07.003","title":"Multiple-Branch Alcohol Septal Ablation Is Associated with Reduced Cardiovascular Events: Insights from a Trans-Pacific Multicentre Registry","abstract":"Background Alcohol septal ablation (ASA) is an established intervention for patients with drug-refractory obstructive hypertrophic cardiomyopathy (HCM). Whereas some patients require ASA with multiple target septal branches due to residual pressure gradient, the prognostic effect of multiple-branch ablation remains unclear. Thus, we aimed to investigate the association of multiple-branch ablation with cardiovascular events after ASA. Methods This multicentre trans-Pacific study enrolled patients who underwent ASA at 4 institutions in the United States and Japan. Patients were categorized into single- and multiple-branch ablation groups. Cardiovascular events, defined as a composite of cardiovascular death, repeated septal reduction therapy, and heart failure hospitalisation, were compared in 2 groups within 1 year after ASA. To address potential confounding, inverse probability of treatment weighting (IPTW) was performed based on the propensity scores for multiple-branch ablation. Odds ratios (ORs) were examined for cardiovascular events before and after the IPTW. Results This study enrolled 151 patients who underwent ASA (single-branch, n=66; multiple-branch, n=85). The multiple-branch ablation group had higher peak gradients, which became comparable after ASA. Cardiovascular events were significantly lower in the multiple-branch ablation group, both before the IPTW (OR 0.33, 95% confidence interval [CI] 0.10–0.96, P =0.049) and after the IPTW (OR 0.27, 95% CI 0.10–0.68, P =0.01). The effect of the reduced incidence was primarily due to a decrease in heart failure hospitalisation. Conclusions This study demonstrated that ASA with multiple target branches may be an effective treatment option for reducing cardiovascular events in morphologically and haemodynamically eligible patients with obstructive HCM.","journal":"CJC Open","year":2025,"id":570340,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9525,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1475651,"name":"Ryota Sato","orcid":"0000-0001-6405-5367","position":1,"is_corresponding":false},{"id":500589,"name":"Atsushi Anzai","orcid":"0000-0002-7474-1309","position":2,"is_corresponding":false},{"id":793530,"name":"Rahul Sakhuja","orcid":null,"position":3,"is_corresponding":false},{"id":704957,"name":"Michael A. Fifer","orcid":"0000-0002-8363-445X","position":4,"is_corresponding":false},{"id":594621,"name":"Yuichi J. Shimada","orcid":"0000-0002-3494-307X","position":5,"is_corresponding":false},{"id":1475652,"name":"Yuichiro Maekawa","orcid":"0000-0002-6792-8458","position":6,"is_corresponding":false},{"id":1086540,"name":"Keitaro Akita","orcid":"0000-0001-5395-1887","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-19T02:57:07.857542Z","pmid":"41180346","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}