1. International prevalence of transthyretin amyloid cardiomyopathy in high-risk patients with heart failure and preserved or mildly reduced ejection fraction.
- Author
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Yun, Sergi, Palladini, Giovanni, Anderson, Lisa J., Cariou, Eve, Wang, Ronnie, Angeli, Franca S., Ebede, Ben, and Garcia-Pavia, Pablo
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CARPAL tunnel syndrome , *VENTRICULAR septum , *VENTRICULAR ejection fraction , *CORONARY disease , *PEPTIDES , *HEART failure , *CARDIAC amyloidosis - Abstract
AbstractBackgroundMethodsResultsConclusionsTransthyretin amyloid cardiomyopathy (ATTR-CM) is an underdiagnosed cause of heart failure (HF).This epidemiology study assessed the international prevalence of ATTR-CM among patients aged ≥60 years with a history of HF, left ventricular ejection fraction (LVEF) >40%, an end-diastolic interventricular septum thickness (IVST) ≥12 mm, but without diagnosed amyloidosis, history of LVEF ≤40%, cardiomyopathy of known cause, severe valvular, or coronary heart disease. ATTR-CM was determined using cardiac scintigraphy alongside exclusionary testing for light chain amyloidosis. The study was terminated early due to slow recruitment, without safety concerns.Overall, 56/315 (18%; 95% CI: 13.7–22.5) patients with evaluable scintigraphy had ATTR-CM, with a numerically higher prevalence in: Europe (24%)
vs. other regions (9% Asia; 5% North America); at specialist vs non-specialist centres (26%vs. 11%); in malesvs. females (24%vs. 10%); and in oldervs . younger patients (e.g. >40% among those ≥85 years). Other risk markers (p <.05) included a history of carpal tunnel syndrome, higher N-terminal pro B-type natriuretic peptide concentration, and higher end-diastolic IVST.ATTR-CM was diagnosed in 18% (95% CI: 13.7–22.5) of evaluable patients with HF, LVEF >40%, and risk markers for ATTR-CM, but no previous diagnosis of amyloidosis. Recruitment bias may have contributed to regional variability. NCT04424914 [ABSTRACT FROM AUTHOR]- Published
- 2024
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