Incidence and causes of hospitalization in patients with transthyretin (ATTR-CA) and light chain (AL-CA) cardiac amyloidosis

Med Clin (Barc). 2024 Apr 12;162(7):e1-e7. doi: 10.1016/j.medcli.2024.01.005. Epub 2024 Feb 28.
[Article in English, Spanish]

Abstract

Introduction and objetives: Cardiac amyloidosis (CA) is a disorder associated with high number of hospital admissions. Given the scarce information available, we propose an analysis of the incidence and causes of hospitalization in this disease.

Material and methods: One hundred and forty-three patients [128 by transthyretin (ATTR-CA) and 15 by light chains (AL-CA)] included in Registro de Amiloidosis Cardiaca de Galicia (AMIGAL) were evaluated, including all hospitalizations.

Results: During a median follow-up of 959 days there were 179 unscheduled hospitalizations [incidence rate (IR) 512.6 admissions per 1000 patients-year], most common due to cardiovascular reasons (n=109, IR 312.2). Most frequent individual cause of hospitalization was heart failure (n=87, TI 249.2). AL-CA was associated with a higher IR of unscheduled hospitalizations than ATTR-CA (IR 781 vs. 483.2; HR 1.62; p=0,029) due to non-cardiovascular admissions (IR 376 vs. 181.2; HR 2.07; p=0.027). Unscheduled admission-free survival at 1 and 3 years in AL-CA was inferior than in ATTR-CA (46.7% and 20.0% vs. 73.4% and 35.2%, respectively; p=0.021).

Conclusions: CA was associated with high incidence of hospitalizations, being heart failure the most frequent individual cause; unscheduled admission-free survival in AL-CA was lower than in ATTR-CA due mostly to non-cardiovascular admissions.

Keywords: Amiloidosis cardiaca; Amiloidosis por cadenas ligeras; Amiloidosis por transtiretina; Cardiac amyloidosis; Heart failure; Hospital admissions; Hospitalizaciones; Hospitalizations; Ingresos hospitalarios; Insuficiencia cardiaca; Light chain amyloidosis; Transthyretin amyloidosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amyloid Neuropathies, Familial* / diagnosis
  • Amyloid Neuropathies, Familial* / epidemiology
  • Amyloid Neuropathies, Familial* / therapy
  • Cardiomyopathies* / epidemiology
  • Cardiomyopathies* / etiology
  • Cardiomyopathies* / therapy
  • Heart Failure* / complications
  • Heart Failure* / epidemiology
  • Heart Failure* / therapy
  • Hospitalization
  • Humans
  • Immunoglobulin Light-chain Amyloidosis* / complications
  • Incidence
  • Prealbumin

Substances

  • Prealbumin