Condition

Hypertrophic Cardiomyopathy

Abnormal thickening of heart muscle

14M
People Affected
137
Active Trials
140K
New Cases/Year
5,000
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Surgical Septal Myectomy
95% Effectiveness• 98% Confidence• 45% Safety• 13 trials• 50K participants
HIGH EvidenceGood Value
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Comparative Safety Scale(Higher is safer)

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Meth💀
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45
DangerousModerateSafe

Time to Effect

Immediate obstruction relief, symptomatic improvement over weeks to months

Duration

One-time procedure, lifetime benefit

Response Rate

95%

Remission Rate

%

Number Needed to Harm (NNH)

12

Common Side Effects:

Post-operative atrial fibrillation: 25%
Complete heart block requiring pacemaker: 8%
Pericardial effusion: 7%
Infection: 3%
Stroke: 1%
Death: 0.5%

Annual Cost of Care

Drug Cost

$100

Monitoring

$500

Side Effects

$500

Total Annual

$1,100

Cost-Effectiveness

GOOD

QALYs Gained

8

ICER

$75,000/QALY

Cost per Responder

$1,158

Treatment Outcomes
Primary Outcomes
Resting Left Ventricular Outflow Tract (LVOT) Gradient70 mmHg
-85.7% (-60 mmHg)
Peak Exercise Left Ventricular Outflow Tract (LVOT) Gradient120 mmHg
-83.3% (-100 mmHg)
NYHA Functional ClassNYHA Class III
-66.7% (Improvement by 2 classes (e.g., Class III to I))
Peak Oxygen Consumption (VO2 Max)18 ml/kg/min
+38.9% (+7 ml/kg/min)
Secondary Benefits
Kansas City Cardiomyopathy Questionnaire (KCCQ) Overall Summary ScoreKCCQ-OS score: 45/100
+55.6% (+25 points)
Severity of Mitral RegurgitationModerate (Grade 2/4)
-50% (Reduction by 1-2 grades (e.g., to Mild or Trivial))
Left Atrial Volume Index50 ml/m^2
-20% (-10 ml/m^2)
Common Side Effects
Post-operative atrial fibrillation
+25%
Complete heart block requiring pacemaker
+8%
Pericardial effusion
+7%

Clinical Trial Phases:

Phase 4
2
Mavacamten
85% Effectiveness• 95% Confidence• 65% Safety• 31 trials• 2K participants
HIGH EvidencePoor ValueDose: 5-15mg once daily
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Comparative Safety Scale(Higher is safer)

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65
DangerousModerateSafe

Time to Effect

Weeks to 3 months

Duration

Lifetime

Response Rate

80%

Remission Rate

%

Number Needed to Treat (NNT)

5

Number Needed to Harm (NNH)

14

Common Side Effects:

Left ventricular ejection fraction reduction: 7%
Dizziness: 20%
Dyspnea: 10%
Syncope: 2%

Annual Cost of Care

Drug Cost

$102,000

Monitoring

$2,000

Side Effects

$200

Total Annual

$104,200

Cost-Effectiveness

POOR

QALYs Gained

4

ICER

$350,000/QALY

Cost per Responder

$130,250

Treatment Outcomes
Primary Outcomes
Change From Baseline to Week 30 in Valsalva Left Ventricular Outflow Tract (LVOT) Peak Gradient
0%
Composite of Decision to Proceed With Septal Reduction Therapy (SRT) and SRT Guideline Eligible at Week 16
0%
Number of Participants With Treatment Emergent Adverse Events and Treatment Emergent Serious Adverse Events
0%
Number of Participants Who Had Cardiovascular Death
0%
Number of Participants Who Experienced Sudden Death
0%
Number of Participants Who Were Hospitalized for Cardiovascular Reasons.
0%
Number of Participants With Heart Failure Due to Systolic Dysfunction, Defined as Asymptomatic LVEF < 50%
0%
Number of Participants With LVEF < 50% as Measured by Echocardiography.
0%
Number of Participants Who Were Experienced Myocardial Infarction
0%
Number of Participants With Ventricular Arrhythmias.
0%
Number of Participants Who Experienced Syncope
0%
Number of Participants Who Experienced Seizures
0%
Number of Participants Who Were Experienced Strokes
0%
Number of Participants With a Change in QT and QTcF Intervals.
0%
Post-exercise Left Ventricular Outflow Tract (LVOT) Gradient Over Time
0%
Resting Left Ventricular Outflow Tract (LVOT) Gradient Over Time3 Participants
-33% (-1.0 Participants)
Post Valsalva Left Ventricular Outflow Tract (LVOT) Gradient Over Time
0%
Participants With >= 1 NYHA Function Class Improvement
0%
Mean Change From Baseline in the Overall KCCQ PRO Score.
0%
Mean Change From Baseline in Serum NT-proBNP.
0%
Number of Participants Who Received Septal Reduction Therapy
0%
Plasma Concentration of Mavacamen Overtime
0%
Secondary Benefits
Change From Baseline to Week 30 in Resting LVOT Peak Gradient
0%
Proportion of Participants Achieving a Valsalva LVOT Peak Gradient < 30 mmHg at Week 30
0%
Proportion of Participants Achieving a Valsalva LVOT Peak Gradient < 50 mmHg at Week 30.
0%
Common Side Effects
Left ventricular ejection fraction reduction
+7%
Dizziness
+20%
Dyspnea
+10%

Clinical Trial Phases:

Phase 3Phase 4
3
Alcohol Septal Ablation
80% Effectiveness• 90% Confidence• 48% Safety• 8 trials• 10K participants
MODERATE-HIGH EvidenceGood Value
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Comparative Safety Scale(Higher is safer)

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48
DangerousModerateSafe

Time to Effect

Immediate obstruction reduction, full symptomatic improvement over weeks to months

Duration

One-time procedure, lifetime benefit

Response Rate

80%

Remission Rate

%

Number Needed to Harm (NNH)

7

Common Side Effects:

Complete heart block requiring pacemaker: 15%
Arrhythmias (AFib, VT): 10%
Pericardial effusion: 5%
Transient chest pain: 30%
Death: 0.8%

Annual Cost of Care

Drug Cost

$100

Monitoring

$500

Side Effects

$1,000

Total Annual

$1,600

Cost-Effectiveness

GOOD

QALYs Gained

7

ICER

$90,000/QALY

Cost per Responder

$2,000

Treatment Outcomes
Primary Outcomes
Resting Left Ventricular Outflow Tract Gradient60 mmHg
-75% (-45 mmHg)
Provoked Left Ventricular Outflow Tract Gradient110 mmHg
-81.8% (-90 mmHg)
Peak Oxygen Consumption (VO2 max)18 mL/kg/min
+22.2% (+4 mL/kg/min)
N-terminal pro-B-type Natriuretic Peptide (NT-proBNP)950 pg/mL
-52.6% (-500 pg/mL)
Secondary Benefits
NYHA Functional ClassClass III (score 3/4)
-33.3% (Improvement by 1 class (e.g., from Class III to II))
Mitral Regurgitation SeverityModerate (grade 2/4)
-50% (Reduction by 1 grade (e.g., from Moderate to Mild))
Minnesota Living with Heart Failure (MLWHF) Questionnaire Score45/105 points
-44.4% (-20 points)
Common Side Effects
Complete heart block requiring pacemaker
+15%
Arrhythmias (AFib, VT)
+10%
Pericardial effusion
+5%

Clinical Trial Phases:

Phase 4
4
Disopyramide
75% Effectiveness• 80% Confidence• 58% Safety• 4 trials• 2K participants
MODERATE-HIGH EvidenceGood ValueDose: 100-200mg three to four times daily
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Comparative Safety Scale(Higher is safer)

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58
DangerousModerateSafe

Time to Effect

Days to weeks

Duration

Lifetime

Response Rate

70%

Remission Rate

%

Number Needed to Treat (NNT)

6

Number Needed to Harm (NNH)

15

Common Side Effects:

Dry mouth: 35%
Blurred vision: 15%
Urinary retention: 10%
Constipation: 15%
QT prolongation/Proarrhythmia: 8%
Hypoglycemia: 1%

Annual Cost of Care

Drug Cost

$700

Monitoring

$1,000

Side Effects

$200

Total Annual

$1,900

Cost-Effectiveness

GOOD

QALYs Gained

7

Cost per Responder

$2,714

Treatment Outcomes
Primary Outcomes
Left Ventricular Outflow Tract (LVOT) Gradient (Resting)65 mmHg
-50% (-32.5 mmHg)
Left Ventricular Outflow Tract (LVOT) Gradient (Provoked)110 mmHg
-60% (-66.0 mmHg)
NYHA Functional ClassMean 2.8 (on a scale of I-IV)
-25% (-0.7 classes)
Peak Oxygen Consumption (VO2)18 mL/kg/min
+15% (+2.7 mL/kg/min)
Secondary Benefits
Quality of Life Score (e.g., KCCQ Overall Summary Score)60 points (out of 100)
+20% (+12 points)
Left Atrial Volume Index (LAVI)45 mL/m²
-10% (-4.5 mL/m²)
Dyspnea Severity Score (e.g., Visual Analog Scale)6.0 (on a 0-10 scale)
-33.3% (-2.0 points)
Common Side Effects
Dry mouth
+35%
Blurred vision
+15%
Urinary retention
+10%

Clinical Trial Phases:

Phase 4
5
Beta-blockers (e.g., Metoprolol, Propranolol)
65% Effectiveness• 90% Confidence• 70% Safety• 500 trials• 50K participants
HIGH EvidenceExcellent ValueDose: Metoprolol succinate 25-200mg daily
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Comparative Safety Scale(Higher is safer)

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70
DangerousModerateSafe

Time to Effect

Hours to days

Duration

Lifetime

Response Rate

65%

Remission Rate

%

Number Needed to Treat (NNT)

8

Common Side Effects:

Fatigue: 15%
Bradycardia: 8%
Hypotension: 7%
Dizziness: 7%
Exacerbation of asthma/COPD: 2%

Annual Cost of Care

Drug Cost

$75

Monitoring

$400

Side Effects

$75

Total Annual

$550

Cost-Effectiveness

EXCELLENT

QALYs Gained

5

Cost per Responder

$846

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+65%
Response Rate
+65%
Common Side Effects
Fatigue
+15%
Bradycardia
+8%
Hypotension
+7%

Clinical Trial Phases:

Phase 4
6
Calcium Channel Blockers (e.g., Verapamil, Diltiazem)
65% Effectiveness• 90% Confidence• 70% Safety• 400 trials• 40K participants
HIGH EvidenceExcellent ValueDose: Verapamil 120-480mg daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
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Exercise🏃
Water💧
70
DangerousModerateSafe

Time to Effect

Hours to days

Duration

Lifetime

Response Rate

65%

Remission Rate

%

Number Needed to Treat (NNT)

8

Common Side Effects:

Constipation (Verapamil): 15%
Headache: 8%
Dizziness: 7%
Bradycardia: 5%
Hypotension: 5%

Annual Cost of Care

Drug Cost

$100

Monitoring

$400

Side Effects

$100

Total Annual

$600

Cost-Effectiveness

EXCELLENT

QALYs Gained

5

Cost per Responder

$923

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+65%
Response Rate
+65%
Common Side Effects
Constipation (Verapamil)
+15%
Headache
+8%
Dizziness
+7%

Clinical Trial Phases:

Phase 4