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
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
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