Early Diagnosis and Outcome in Patients With Wild-Type Transthyretin Cardiac Amyloidosis.

Details

Serval ID
serval:BIB_94BFC251D82F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Early Diagnosis and Outcome in Patients With Wild-Type Transthyretin Cardiac Amyloidosis.
Journal
Mayo Clinic proceedings
Author(s)
Fumagalli C., Zampieri M., Perfetto F., Zocchi C., Maurizi N., Tassetti L., Ungar A., Gabriele M., Nardi G., Del Monaco G., Baldini K., Tomberli A., Tomberli B., Marchionni N., Di Mario C., Olivotto I., Cappelli F.
ISSN
1942-5546 (Electronic)
ISSN-L
0025-6196
Publication state
Published
Issued date
08/2021
Peer-reviewed
Oui
Volume
96
Number
8
Pages
2185-2191
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Whether diagnostic timing in transthyretin (TTR) cardiac amyloidosis (CA) predisposes patients to worse outcomes is unresolved. We aimed to describe the long-term association of diagnostic timing (time from first onset of symptoms consistent with CA leading to medical contact to definitive diagnosis) with mortality in patients with wild-type TTR-CA (ATTRwt-CA). Overall, we reviewed the medical records of 160 patients seen at a tertiary care amyloidosis unit from January 1, 2016, to January 1, 2020 (median [interquartile range] follow-up, 21 [10 to 34] months), and compared them by survival. Median diagnostic timing was 4 (2 to 12) months and was longer in nonsurvivors (9 [3 to 15] vs 3 [1 to 7] months; P<.001). Patients diagnosed 6 or more months after symptom onset had higher mortality, with a median survival of 30 months (95% CI, 22 to 37 months). On Cox multivariable analysis, timing was independently associated with all-cause mortality (hazard ratio per month increase, 1.049 [95% CI, 1.017 to 1.083]) together with age at diagnosis, disease stage, New York Heart Association class, and coronary artery disease. In conclusion, diagnostic timing of ATTRwt-CA is associated with mortality. Timely diagnosis is warranted whenever "red flags" are present.
Keywords
Aged, Aged, 80 and over, Amyloid Neuropathies, Familial/diagnosis, Cardiomyopathies/diagnosis, Cardiomyopathies/metabolism, Diagnosis, Differential, Early Diagnosis, Electrocardiography, Female, Humans, Male, Microscopy, Immunoelectron, Radionuclide Imaging
Pubmed
Web of science
Create date
23/05/2024 13:08
Last modification date
24/05/2024 7:05
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