1. Multiorgan Dysfunction and Associated Prognosis in Transthyretin Cardiac Amyloidosis
- Author
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Adam Ioannou, Christian Nitsche, Aldostefano Porcari, Rishi K. Patel, Yousuf Razvi, Muhammad U. Rauf, Ana Martinez‐Naharro, Lucia Venneri, Antonella Accietto, Lucrezia Netti, Francesco Bandera, Ruta Virsinskaite, Tushar Kotecha, Dan Knight, Aviva Petrie, Carol Whelan, Ashutosh Wechalekar, Helen Lachmann, Philip N. Hawkins, Julian D. Gillmore, and Marianna Fontana more...
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blood biomarkers ,heart failure ,mortality ,transthyretin cardiac amyloidosis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Transthyretin cardiac amyloidosis (ATTR‐CA) is a progressive and ultimately fatal cardiomyopathy. Biomarkers reflecting multiorgan dysfunction are of increasing importance in patients with heart failure; however, their significance in ATTR‐CA remains largely unknown. The aims of this study were to characterize the multifaceted nature of ATTR‐CA using blood biomarkers and assess the association between blood biomarkers and prognosis. Methods and Results This is a retrospective cohort study of 2566 consecutive patients diagnosed with ATTR‐CA between 2007 and 2023. Anemia (39%), high urea (52%), hyperbilirubinemia (18%), increased alkaline phosphatase (16%), increased CRP (C‐reactive protein; 27%), and increased troponin (98.2%) were common findings in the overall population, whereas hyponatremia (6%) and hypoalbuminemia (2%) were less common. These abnormalities were most common in patients with p.(V142I) hereditary ATTR‐CA, and became more prevalent as the severity of cardiac disease increased. Multivariable Cox regression analysis demonstrated that anemia (hazard ratio [HR], 1.19 [95% CI, 1.04–1.37]; P=0.01), high urea (HR, 1.23 [95% CI, 1.04–1.45]; P=0.01), hyperbilirubinemia (HR, 1.32 [95% CI, 1.13–1.57; P=0.001), increased alkaline phosphatase (HR, 1.20 [95% CI, 1.01–1.42; P=0.04), hyponatremia (HR, 1.65 [95% CI, 1.28–2.11]; P56 ng/L (HR, 1.72 [95% CI, 1.46–2.03]; P more...
- Published
- 2024
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