In AL cardiac amyloidosis, each 1 run/day increase in VT raises mortality risk by 3.2% (HR 1.032), and each VT beat increase raises risk by 2.4% (HR 1.024).
Do baseline ventricular tachycardia characteristics predict overall survival in patients with newly diagnosed light-chain cardiac amyloidosis?
Baseline ventricular tachycardia characteristics, specifically average runs and maximum beats, are independent predictors of mortality in patients with newly diagnosed light-chain cardiac amyloidosis.
Tasa de eventos absoluta: 0% vs 0%
Abstract Background Ventricular tachycardia is common in light-chain cardiac amyloidosis (AL-CA). The prognostic significance of such ventricular tachycardia is unclear. Purpose We aimed to evaluate the prognostic significance of ventricular tachycardia characteristics in AL-CA patients. Methods Patients with newly diagnosed AL-CA admitted to our centre were prospectively enrolled. Baseline ventricular tachycardia characteristics were investigated by continuous noninvasive electrocardiography monitoring for 7 days before chemotherapy given by hematologists. Results A total of 70 patients were enrolled from 1st Feb. 2023 to 31st Dec. 2023. Baseline characteristics were listed in Table 1. Patients were followed up for median 391.5 (131.0,521.3) days. Overall survival rate was 65.7% (46/70). Receiver operator characteristic curve analysis showed baseline average ventricular tachycardia runs (area under the curve of 0.667; 95% CI 0.526-0.808, P=0.022; best tradeoff value 0.925 runs/day, Youden index 0.312; sensitivity 33.3%; specificity 97.8%) and maximum ventricular tachycardia beats (area under the curve of 0.693; 95% CI 0.552-0.834, P=0.008; best tradeoff value 6.50 beats, Youden index 0.393; sensitivity 45.8%; specificity 93.5%) were associated with overall survival rate. Kaplan-Meier curve analysis for overall survival rates were showed in Figure 1A & 1B. Multivariate Cox regressive models after adjusting for Mayo 2012 stage showed average ventricular tachycardia runs (per 1 runs/day increase: HR 1.032, 95% CI 1.006-1.059, P=0.017), and maximum ventricular tachycardia beat (per 1 beat increase: HR 1.024, 95% CI 1.009-1.038, P=0.001) were independent predictors of mortality. Conclusion Baseline ventricular tachycardia characteristics are associated with overall survival rate of light-chain cardiac amyloidosis.
Yang et al. (Sat,) reported a other. In AL cardiac amyloidosis, each 1 run/day increase in VT raises mortality risk by 3.2% (HR 1.032), and each VT beat increase raises risk by 2.4% (HR 1.024).